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PROGRESS IN RESEARCH
405
complications; the disturbance to the patient was insignificant and postoperative discomfort slight. DOHLMAN’S18 cesophagoscope has a jaw-like slit in the distal end to fix the common wall, and acts as the second electrode while the diathermy forceps are used to perform the operation by stages. Two to three interventions at about fortnightly intervals are usually sufficient to give lasting relief. HARRISON 13 obtained good results in his series of 17 patients and found the operation particularly useful in the elderly. In the majority of cases, by the time the patient is seen by the surgeon, the pouch has reached a considerable size and symptoms are pronounced. Total one-
Annotations PROGRESS IN RESEARCH
FROM the many research studies which the Medical Research Council supports, some each year are selected for review in its annual report. Each report thus contains a small collection of authoritative essays, which are readable and up to date and do not confine themselves to work done under the Council’s auspices. Because the essays could obviously be read with advantage and pleasure by a great many people-especially practising doctorswho would not normally buy the full report, the Council has once again had them reprinted, under the title of Current Medical Research." This year’s issue1 covers the following fourteen topics: The Spinal Cord in Poliomyelitis The Architecture of a Protein Molecule Community Surveys in the The Development of RespiraStudy of Rheumatoid Arthritis
stage resection of the
with careful repair and antibiotic cover is usually regarded as the treatment of choice in reasonably fit patients. There is a place for diathermy division of the septum between the diverticulum and the oesophagus, especially in the frail, ill, and elderly patient; but this should not be undertaken by the occasional cesophagoscopist, and it is no substitute for diverticulectomy, which obviates the necessity for repeated admissions and the risks (admittedly small) of infection, haemorrhage, or malignancy supervening in the remaining pouch. With modern surgical and anxsthetic methods, ever fewer patients are unsuitable for a single-stage excision of a pharyngeal pouch. sac
The members of the Medical Research Council
are:
The Earl of Limerick (chairman), Sir Geoffrey Vickers (treasurer), Mr. Richard Fort, M.P., Sir George Pickering, F.R.C.P., Prof. Bradford Hill, Prof. G. F. Marrian, Prof. R. C. Garry, F.R.F.P.S., Mr. H. J. Seddon, F.R.C.S., Prof. G. Payling Wright, F.R.C.P., Dr. Denis Hill, Prof. C. H. Stuart-Harris, F.R.C.P., and Prof. A. A. Miles, F.R.C.P., with Sir Harold Himsworth, F.R.C.P., as secretary.
The Clinical Research Board consists of: Sir Geoffrey Jefferson, F.R.C.S. (chairman), Sir Charles Dodds, F.R.C.P., Sir Arthur Gemmell, F.R.C.O.G., Dr. Denis Hill, Prof. R. B. Hunter, F.R.C.P.E., Prof. C. F. W. Illingworth, F.R.C.S.E., Sir George Pickering, Mr. Seddon, Dr. W. P. H. Sheldon, Professor Stuart-Harris, and Prof. B. W. Windeyer, F.R.C.S., with Dr. F. J. C. Herrald as secretary. THE CHRONIC RESPIRATOR PATIENT
"
OF late years the treatment of patients with respiratory paralysis from whatever cause has progressed remarkably; and as a result patients with poliomyelitis have survived very severe attacks but have been left with permanent The Mechanism of Fever tors2 respiratory weakness. The total number is not large, but Influenza in 1957 5-Hydroxytryptamine (HT) it will increase each year until vaccination against polioFemale Sex Hormones and their "NewViruses of the Respiramyelitis is available to those beyond adolescence, for it is Quantitative Estimation tory and Intestinal Tracts in young and middle-aged adults that poliomyelitis is Studies Radioon Viral Interference and the SubExperimental strontium stance " Interferon most severe and leaves most permanent damage. Despite The Changing Pattern of SeroExperimental Leukxmia the relatively small number of these patients, they constiGenetics of Eye Disease logical Tests for Syphilis tute an important clinical and administrative problem, More detailed and comprehensive information about for they make heavy demands on nursing and medical the work now proceeding with the Council’s help will be staff. found in the report itself.3 In the year 1956-57, ended last Dooley1 has reviewed the long-term care of patients September, its establishments consisted of the National who require artificial aid to respiration, basing his figures Institute for Medical Research, the M.R.C. laboratories on a review in Britain in June, 1956. At the upper end in the Gambia, 44 research units, and 21 research groups, of the scale are those who need assistance with respiration and it was also supporting research at cancer institutes. for part of the day or perhaps only at night; and Dooley From public funds in the financial year 1956-57 it spent records such a patient who was a house-physician in a E2,541,549 on ordinary account and E51,230 on non- London teaching hospital, travelling about the hospital recurrent account, compared with E2,325,430 and E76,226 in an electrically operated chair. For this type of patient in the previous year. Of this money 196% was spent on a cuirass or a breathing-jacket is excellent, the principal the National Institute for Medical Research, 588% on disadvantage being that some patients find them irremediresearch units, groups, and external staff, 7-8% on special ably cold. For the most severely paralysed-those who grants, and 87% on temporary research grants and at best can breathe unassisted for a few minutes-the training awards. The income from benefactions, which cuirass and the breathing-jacket are not suitable, and these are gratefully acknowledged, was £115,785. For the are either nursed in a tank respirator or have a financial year 1957-58 Parliament voted a grant-in-aid of patients tracheotomy and are given artificial respiration by interE2,680,500, a supplementary grant-in-aid of E95.000 mittent positive pressure. In either case their spon’necessitated by pay awards and other obligatory commit- taneous breathing may be much improved by glossoments arising during the year), and E37,500 on non-recurpharyngeal (" frog ") breathing. Even if these patients rent account. The cost of the Public Health Laboratory have very little power in their limbs it is quite wrong to Service, which is administered by the Council, is met suppose that nothing can be done for them. With suitseparately by the Ministry of Health. able apparatus they can read, turning over the pages 1958. Pp. 54. Current Medical Research. H.M. Stationery Office. with an electric switch operated, if necessary, by the chin. 3: 6d. Obtainable from H.M.S.O., York House, Kingsway, London, or bookseller. Electric W.C.2, through any typewriters are so light to operate that those with was reviewed in article of "
,
2 This essay 3 Report of M.R.C.
our leading Aug. 9, p. 305. for year 1956-57. H.M. Stationery Office. Cmd. 453. 13s.
1.
Dooley, D. Mon. Bull. Minist. Hlth Lab. Serv. 1958, 17, 124.
complications; the disturbance to the patient was insignificant and postoperative discomfort slight. DOHLMAN’S18 cesophagoscope has a jaw-like slit in the distal end to fix the common wall, and acts as the second electrode while the diathermy forceps are used to perform the operation by stages. Two to three interventions at about fortnightly intervals are usually sufficient to give lasting relief. HARRISON 13 obtained good results in his series of 17 patients and found the operation particularly useful in the elderly. In the majority of cases, by the time the patient is seen by the surgeon, the pouch has reached a considerable size and symptoms are pronounced. Total one-
Annotations PROGRESS IN RESEARCH
FROM the many research studies which the Medical Research Council supports, some each year are selected for review in its annual report. Each report thus contains a small collection of authoritative essays, which are readable and up to date and do not confine themselves to work done under the Council’s auspices. Because the essays could obviously be read with advantage and pleasure by a great many people-especially practising doctorswho would not normally buy the full report, the Council has once again had them reprinted, under the title of Current Medical Research." This year’s issue1 covers the following fourteen topics: The Spinal Cord in Poliomyelitis The Architecture of a Protein Molecule Community Surveys in the The Development of RespiraStudy of Rheumatoid Arthritis
stage resection of the
with careful repair and antibiotic cover is usually regarded as the treatment of choice in reasonably fit patients. There is a place for diathermy division of the septum between the diverticulum and the oesophagus, especially in the frail, ill, and elderly patient; but this should not be undertaken by the occasional cesophagoscopist, and it is no substitute for diverticulectomy, which obviates the necessity for repeated admissions and the risks (admittedly small) of infection, haemorrhage, or malignancy supervening in the remaining pouch. With modern surgical and anxsthetic methods, ever fewer patients are unsuitable for a single-stage excision of a pharyngeal pouch. sac
The members of the Medical Research Council
are:
The Earl of Limerick (chairman), Sir Geoffrey Vickers (treasurer), Mr. Richard Fort, M.P., Sir George Pickering, F.R.C.P., Prof. Bradford Hill, Prof. G. F. Marrian, Prof. R. C. Garry, F.R.F.P.S., Mr. H. J. Seddon, F.R.C.S., Prof. G. Payling Wright, F.R.C.P., Dr. Denis Hill, Prof. C. H. Stuart-Harris, F.R.C.P., and Prof. A. A. Miles, F.R.C.P., with Sir Harold Himsworth, F.R.C.P., as secretary.
The Clinical Research Board consists of: Sir Geoffrey Jefferson, F.R.C.S. (chairman), Sir Charles Dodds, F.R.C.P., Sir Arthur Gemmell, F.R.C.O.G., Dr. Denis Hill, Prof. R. B. Hunter, F.R.C.P.E., Prof. C. F. W. Illingworth, F.R.C.S.E., Sir George Pickering, Mr. Seddon, Dr. W. P. H. Sheldon, Professor Stuart-Harris, and Prof. B. W. Windeyer, F.R.C.S., with Dr. F. J. C. Herrald as secretary. THE CHRONIC RESPIRATOR PATIENT
"
OF late years the treatment of patients with respiratory paralysis from whatever cause has progressed remarkably; and as a result patients with poliomyelitis have survived very severe attacks but have been left with permanent The Mechanism of Fever tors2 respiratory weakness. The total number is not large, but Influenza in 1957 5-Hydroxytryptamine (HT) it will increase each year until vaccination against polioFemale Sex Hormones and their "NewViruses of the Respiramyelitis is available to those beyond adolescence, for it is Quantitative Estimation tory and Intestinal Tracts in young and middle-aged adults that poliomyelitis is Studies Radioon Viral Interference and the SubExperimental strontium stance " Interferon most severe and leaves most permanent damage. Despite The Changing Pattern of SeroExperimental Leukxmia the relatively small number of these patients, they constiGenetics of Eye Disease logical Tests for Syphilis tute an important clinical and administrative problem, More detailed and comprehensive information about for they make heavy demands on nursing and medical the work now proceeding with the Council’s help will be staff. found in the report itself.3 In the year 1956-57, ended last Dooley1 has reviewed the long-term care of patients September, its establishments consisted of the National who require artificial aid to respiration, basing his figures Institute for Medical Research, the M.R.C. laboratories on a review in Britain in June, 1956. At the upper end in the Gambia, 44 research units, and 21 research groups, of the scale are those who need assistance with respiration and it was also supporting research at cancer institutes. for part of the day or perhaps only at night; and Dooley From public funds in the financial year 1956-57 it spent records such a patient who was a house-physician in a E2,541,549 on ordinary account and E51,230 on non- London teaching hospital, travelling about the hospital recurrent account, compared with E2,325,430 and E76,226 in an electrically operated chair. For this type of patient in the previous year. Of this money 196% was spent on a cuirass or a breathing-jacket is excellent, the principal the National Institute for Medical Research, 588% on disadvantage being that some patients find them irremediresearch units, groups, and external staff, 7-8% on special ably cold. For the most severely paralysed-those who grants, and 87% on temporary research grants and at best can breathe unassisted for a few minutes-the training awards. The income from benefactions, which cuirass and the breathing-jacket are not suitable, and these are gratefully acknowledged, was £115,785. For the are either nursed in a tank respirator or have a financial year 1957-58 Parliament voted a grant-in-aid of patients tracheotomy and are given artificial respiration by interE2,680,500, a supplementary grant-in-aid of E95.000 mittent positive pressure. In either case their spon’necessitated by pay awards and other obligatory commit- taneous breathing may be much improved by glossoments arising during the year), and E37,500 on non-recurpharyngeal (" frog ") breathing. Even if these patients rent account. The cost of the Public Health Laboratory have very little power in their limbs it is quite wrong to Service, which is administered by the Council, is met suppose that nothing can be done for them. With suitseparately by the Ministry of Health. able apparatus they can read, turning over the pages 1958. Pp. 54. Current Medical Research. H.M. Stationery Office. with an electric switch operated, if necessary, by the chin. 3: 6d. Obtainable from H.M.S.O., York House, Kingsway, London, or bookseller. Electric W.C.2, through any typewriters are so light to operate that those with was reviewed in article of "
,
2 This essay 3 Report of M.R.C.
our leading Aug. 9, p. 305. for year 1956-57. H.M. Stationery Office. Cmd. 453. 13s.
1.
Dooley, D. Mon. Bull. Minist. Hlth Lab. Serv. 1958, 17, 124.