- Email: [email protected]
PORTEX TRACHEOSTOMY TUBE
595
important factors for the flux and concentration of in plasma.7 The flux of F.F.A. was not studied, either in our patients, or in those previously studied by Hamlin et al. and by Havel.1 As regards the changes in F.F.A. concentration, our patients differed from the two previously studied. It is therefore possible that there are two subgroups of postural hypotension, one with and one without disturbed
are
F.F.A.
mobilisation of
This hypothesis that prior immunisation is not necessary is supported by the finding that lymphoblastoid cells develop in mixtures of blood-leucocytes from two normal
persons. 16 This study was Cancer Institute.
LARS ORÖ.
in children admitted to hospital with severe gastroenteritis and electrolyte disturbances. Since then, in a group of some 40 infants with severe gastroenteritis, we have found 20% with true blood-glucose levels of 200-500 mg. per 100 ml., and 67% with blood-glucose levels above 120 mg. per 100 ml. In the group with levels above 200 mg. per 100 ml., the mean serum-sodium and serum-chloride levels were higher than in the other infants with lower blood-glucose levels, and the serum-potassium and blood-pH were lower (mean serumsodium 150 mEq. per litre; serum-chloride 123 mEq. per litre; serum-potassium 4-3 mEq. per litre; and pH 7-08). As a group, these children were more severely ill. The first urine in these dehydrated infants was obtained usually several hours after hydration was begun, and on no occasion contained glucose. We were unable to correlate intake of sugar before admission with the hyperglycaemia, and do not believe this to be the cause.
In most of these infants treatment with electrolytes in 5% glucose solution brought the blood-glucose down to normal or near-normal levels within several hours.
STANLEY LEVIN CARMI GELLER-BERNSTEIN.
LYMPHOBLASTOID TRANSFORMATION OF RAT AND HUMAN LYMPHOCYTES BY RABBIT SERA SIR,- Tuberculin and other antigens 8-14 have been found to transform human lymphocytes into lymphoblastoid cells. Most workers 9-14 have considered that the antigens act only on lymphocytes of persons who have been immunised or sensitised to the antigen. Even the stimulation of human lymphocytes by phytohaemagglutinin is supposed to have an immunological basis.9 12 15
Veterans Administration Hospital, Hines, Illinois, U.S.A.
SIR,-In
your
leading article (Sept. 5)
control this disease is for the failure " neglect of fundamental research in a subject which medical opinion has too long despised and ignored, an attitude once determined by moral reprobation ".
the main
reason
But does not this attitude still exist, if only for the reason that venereal disease is contracted during sexual intercourse, usually premarital ? The impression that doctors set themselves up as judges of moral conduct was certainly conveyed in the report issued this year by the British Medical Association on Venereal Disease and Young People. Too many doctors allow moral considerations to influence their attitude, which explains why so many patients are made to feel that their infection is the visible evidence of sin and why the consulting-room appears not unlike the dock in the Old
Bailey. In these circumstances can we be surprised if they are reluctant to seek medical advice ? And even now may this not be partly responsible for our failure to control venereal disease ? EUSTACE CHESSER. London, W.1. PORTEX TRACHEOSTOMY TUBE A. E. LLOYD-DODD (Portland Plastics Ltd., ReachMr. fields, Hythe, Kent) writes: The letters from Dr. Gilston (Aug. 22) and Dr. Hoskins (Sept. 5) regarding the ’Portex’ cuffed tracheostomy tube prompt me to reaffirm that manufacture of these tubes has been modified to ensure that the Nosworthy fitting does not become detached. Secondly, I would reiterate Dr. Hoskins’ cautionary note regarding maximum quantities of air which these cuffs can safely hold: excessive inflation is hazardous in any type of tube, and it is, of course, an indication that the patient’s tube is too small for his trachea." "
16.
Bain, B., Vas,
M.
R., Lowenstein, L. Blood, 1964, 23, 108.
Public Health Infectious Diseases in England and Wales
We have observed that inactivated sera of normal rabbits in 2 to 4 days mitoses and lymphoblastoid cells in cultures of blood-lymphocytes derived from normal men and rats. The media used in these experiments were a mixture of equal parts of TC 199 and inactivated sera of rabbits. The number of transformed lymphocytes was approximately the same as that produced by tuberculin in suspensions of human lymphocytes but was less than that produced by phytohaemagglutinin. No mitoses or transformations were observed in control cultures in homologous sera.
Although several explanations must be considered, these findings suggest that an antigen (rabbit sera) can produce transformation of non-sensitised lymphocytes.
13. 14. 15.
Carlson, L. A., Pernow, B. J. Lab. clin. Med. 1961, 58, 673. Schrek, R. Amer. Rev. resp. Dis. 1963, 87, 734. Pearmain, G., Lycette, R. R., Fitzgerald, P. H. Lancet, 1963, i, 637. Marshall, W. H., Roberts, K. B. ibid. p. 773. Elves, M. W., Roath, S., Israëls, M. C. G. ibid. p. 806. Hirschhorn, K., Kolodny, R. L., Hashem, N., Bach, F. ibid. 1963, ii, 305. Matsaniotis, N. S., Tsenghi, C. J. ibid. 1964, i, 989. Holland, P., Mauer, A. M. ibid. p. 1368. Schrek, R., Stefani, S. Fed. Proc. 1963, 22, 428.
you state that
to
produced
7. 8. 9. 10. 11. 12.
-
ROBERT SCHREK LLOYD M. ELROD.
THE SPREAD OF GONORRHŒA
ALIMENTARY HYPERGLYCÆMIA SIMULATING DIABETIC KETOSIS SIR, The report by Dr. Burman and Dr. Glaspole (July 25) deserves comment. About two years ago we found high levels of blood-glucose
Department of Pediatrics, Kaplan Hospital, Rechovoth, Israel.
07541 from the National -
F.F.A.
Department of Internal Medicine, Karolinska Sjukhuset, and King Gustaf V Research Institute, Stockholm 60, Sweden.
supported by grant CA
*Not
including late
returns.
important factors for the flux and concentration of in plasma.7 The flux of F.F.A. was not studied, either in our patients, or in those previously studied by Hamlin et al. and by Havel.1 As regards the changes in F.F.A. concentration, our patients differed from the two previously studied. It is therefore possible that there are two subgroups of postural hypotension, one with and one without disturbed
are
F.F.A.
mobilisation of
This hypothesis that prior immunisation is not necessary is supported by the finding that lymphoblastoid cells develop in mixtures of blood-leucocytes from two normal
persons. 16 This study was Cancer Institute.
LARS ORÖ.
in children admitted to hospital with severe gastroenteritis and electrolyte disturbances. Since then, in a group of some 40 infants with severe gastroenteritis, we have found 20% with true blood-glucose levels of 200-500 mg. per 100 ml., and 67% with blood-glucose levels above 120 mg. per 100 ml. In the group with levels above 200 mg. per 100 ml., the mean serum-sodium and serum-chloride levels were higher than in the other infants with lower blood-glucose levels, and the serum-potassium and blood-pH were lower (mean serumsodium 150 mEq. per litre; serum-chloride 123 mEq. per litre; serum-potassium 4-3 mEq. per litre; and pH 7-08). As a group, these children were more severely ill. The first urine in these dehydrated infants was obtained usually several hours after hydration was begun, and on no occasion contained glucose. We were unable to correlate intake of sugar before admission with the hyperglycaemia, and do not believe this to be the cause.
In most of these infants treatment with electrolytes in 5% glucose solution brought the blood-glucose down to normal or near-normal levels within several hours.
STANLEY LEVIN CARMI GELLER-BERNSTEIN.
LYMPHOBLASTOID TRANSFORMATION OF RAT AND HUMAN LYMPHOCYTES BY RABBIT SERA SIR,- Tuberculin and other antigens 8-14 have been found to transform human lymphocytes into lymphoblastoid cells. Most workers 9-14 have considered that the antigens act only on lymphocytes of persons who have been immunised or sensitised to the antigen. Even the stimulation of human lymphocytes by phytohaemagglutinin is supposed to have an immunological basis.9 12 15
Veterans Administration Hospital, Hines, Illinois, U.S.A.
SIR,-In
your
leading article (Sept. 5)
control this disease is for the failure " neglect of fundamental research in a subject which medical opinion has too long despised and ignored, an attitude once determined by moral reprobation ".
the main
reason
But does not this attitude still exist, if only for the reason that venereal disease is contracted during sexual intercourse, usually premarital ? The impression that doctors set themselves up as judges of moral conduct was certainly conveyed in the report issued this year by the British Medical Association on Venereal Disease and Young People. Too many doctors allow moral considerations to influence their attitude, which explains why so many patients are made to feel that their infection is the visible evidence of sin and why the consulting-room appears not unlike the dock in the Old
Bailey. In these circumstances can we be surprised if they are reluctant to seek medical advice ? And even now may this not be partly responsible for our failure to control venereal disease ? EUSTACE CHESSER. London, W.1. PORTEX TRACHEOSTOMY TUBE A. E. LLOYD-DODD (Portland Plastics Ltd., ReachMr. fields, Hythe, Kent) writes: The letters from Dr. Gilston (Aug. 22) and Dr. Hoskins (Sept. 5) regarding the ’Portex’ cuffed tracheostomy tube prompt me to reaffirm that manufacture of these tubes has been modified to ensure that the Nosworthy fitting does not become detached. Secondly, I would reiterate Dr. Hoskins’ cautionary note regarding maximum quantities of air which these cuffs can safely hold: excessive inflation is hazardous in any type of tube, and it is, of course, an indication that the patient’s tube is too small for his trachea." "
16.
Bain, B., Vas,
M.
R., Lowenstein, L. Blood, 1964, 23, 108.
Public Health Infectious Diseases in England and Wales
We have observed that inactivated sera of normal rabbits in 2 to 4 days mitoses and lymphoblastoid cells in cultures of blood-lymphocytes derived from normal men and rats. The media used in these experiments were a mixture of equal parts of TC 199 and inactivated sera of rabbits. The number of transformed lymphocytes was approximately the same as that produced by tuberculin in suspensions of human lymphocytes but was less than that produced by phytohaemagglutinin. No mitoses or transformations were observed in control cultures in homologous sera.
Although several explanations must be considered, these findings suggest that an antigen (rabbit sera) can produce transformation of non-sensitised lymphocytes.
13. 14. 15.
Carlson, L. A., Pernow, B. J. Lab. clin. Med. 1961, 58, 673. Schrek, R. Amer. Rev. resp. Dis. 1963, 87, 734. Pearmain, G., Lycette, R. R., Fitzgerald, P. H. Lancet, 1963, i, 637. Marshall, W. H., Roberts, K. B. ibid. p. 773. Elves, M. W., Roath, S., Israëls, M. C. G. ibid. p. 806. Hirschhorn, K., Kolodny, R. L., Hashem, N., Bach, F. ibid. 1963, ii, 305. Matsaniotis, N. S., Tsenghi, C. J. ibid. 1964, i, 989. Holland, P., Mauer, A. M. ibid. p. 1368. Schrek, R., Stefani, S. Fed. Proc. 1963, 22, 428.
you state that
to
produced
7. 8. 9. 10. 11. 12.
-
ROBERT SCHREK LLOYD M. ELROD.
THE SPREAD OF GONORRHŒA
ALIMENTARY HYPERGLYCÆMIA SIMULATING DIABETIC KETOSIS SIR, The report by Dr. Burman and Dr. Glaspole (July 25) deserves comment. About two years ago we found high levels of blood-glucose
Department of Pediatrics, Kaplan Hospital, Rechovoth, Israel.
07541 from the National -
F.F.A.
Department of Internal Medicine, Karolinska Sjukhuset, and King Gustaf V Research Institute, Stockholm 60, Sweden.
supported by grant CA
*Not
including late
returns.