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STREPTOCOCCAL INFECTIONS AND PREGNANCY
600 (2) Appearance of external genitalia, possibly with photograph. (3) Appearance of internal genitalia and genital ducts. (4) Histological appearance of both gonads. (5) Appearance and size of the adrenal glands. (6) Gestation age. We would be grateful if interested workers could communicate to us their findings, or alternatively submit either histological sections or necropsy material. In the latter event we would like to suggest that a fragment of skin and both gonads be put into Bouin’s fixative, and despatched to us as soon as possible after collection, together with information concerning points 2, 3, 5, and 6 listed above. Keats’ House, Guy’s Hospital, London, S.E.1. The Bernhard Baron Memorial Research Laboratories, Queen Charlotte’s Maternity Hospital, London, W.6.
MECHANICAL
FACTORS
PAUL E. POLANI.
A. E. CLAIREAUX.
beneficial effect on the incidence of foetal abnormalities and of the complications of pregnancy and labour-particularly toxaemia, which remains the chief hazard to the life of the expectant mother. T. W. BUCHAN. RECURRENT APHTHOUS STOMATITIS
10 prompts me to otler comment based on observations made in the treatment of this disease. In a paper to be publishedmy colleagues and I di attention to the prevalence of herpetiform lesions and their treatment with gamma-globulin. It is our belief that aphthous ulcers are not caused by herpes virus but by an unknown virus since patients suffering from these ulcers have a low antibody titre against herpes virus while those suffering from herpetic stomatitis frequently have a high antibody titre against the homologOM
SIR,—Your annotation of Aug.
some
antigen. IN ATHEROSCLEROSIS
SiR,-Dr. Robertson and I are grateful to Dr. Hamilton (Aug. 17) for drawing our attention to the proper priority which should have been given to Dr. J. C. Paterson’s name in reference to intimal haemorrhage in our report.! I must confess that in drawing up our list of references I had Dr. Paterson’s later paper before me and carelessly overlooked his earlier one on the same subject. Department of Pathology Royal Victoria Infirmary, Newcastle upon Tyne, 1.
J. B. DUGUID.
STREPTOCOCCAL INFECTIONS AND PREGNANCY SIR,—There is a good deal of evidence on general grounds to incriminate the streptococcus as an infecting agent which might have important effects in early pregnancy, and recently it has been accused of possibly accounting for unexplained foetal abnormalities.2
Since various forms of stress
believed that this blood fraction would contain antibodies this unknown virus. We have treated approximately 50 patients who received varying doses from 3 to 10 ml. Some patients required one injection, while others received additional injections for several days or several weeks. In most instances, prompt recovery was observed. One of these patients suffered from a severe case of Behet’s syndrome and the response was dramatic after many other forms of therapy failed, including we
against
chlortetracycline. Others may wish to try this treatment for a trouble. condition which plagues the patient and humbles the physician and dentist. some
Merck
Sharp & Dohme Research Laboratories, West Point, Pennsylvania, U.S.A.
This
hypothesis is quite rational, significant association at the clinical
and though no level has been demonstrated there is some circumstantial evidence in its favour on the statistical side. When the regional variations of mortality from congenital malformations in the first year of life are compared with the variations of mortality from streptococcal or post-streptococcal diseases, a high level of correlation is obtained. It is of the order + 0.7, t = 3-15. The rates for the decennium 1932-41 are shown in the accompanying table.
(traumatic, physiological, or
emotional) seem to precipitate a crop of aphthous ulcers, we postulated that the resulting increase in endogenous hydro. cortisone might interfere with the immune mechanism. Since gamma-globulin contains antibodies against various viruses.
LYON P. STREAN.
ACNE VULGARIS
SIR,—In. January you very kindly published2a lecture of mine on this subject. There are two items of informa tion which I should now like to add. (1) At the time the lecture was delivered I was not aware of the interesting paper by Van Scott and MacCardle 3 published in the United States, in which they stated that the earliest change in acne is hyper. keratinisation of the excretory duct of the sebaceous gland which results in the deposition of a keratinous plug in the follicular neck. They tentatively suggested that the products of the sebaceous gland may biochemical initiate the hyperkeratosis that leads to the principal morphological lesion of acne." If confirmed their observation is of considerable importance, and their suggestion might well be considered in relation to the work of 4 concerning the increase of 17-ketosteroid excretion through the sebum in acne vulgaris. (2) During the past ten months I have treated more than 35 cases of acne vulgaris both in males and females with tablets each containing 50 i.u. serum-gonadotrophin. The standard dose has been 2 tablets per day but sometimes twice this amount has been given. An important matter in this treatment is that the tablets must be dissolved in the mouth. At first I regarded this therapy. though it was originated by Aron-Brunetière5 with considerable scepticism, and it will require quite a Ion.’ period of observation to determine whether mv first "
Dubovyi
In view of the possibility that the streptococcus is in this and in other disturbances associated
implicated with
pregnancy,3
it
seems
justifiable to
arrange controlled
field trials to test the influence of prophylaxis against streptococcal infection in the early months of pregnancy, on the same lines as prophylaxis against recurrences of rheumatic fever. The new long-acting preparations of penicillin and sulphonamide would be useful here. It would be of great interest to know whether they had a 1. Duguid, J. B., Robertson, W. B. Lancet, 1957, i, 1205. 2. Pleydell, M. J. Ibid, p. 1314. 3. Buchan, T. W. Brit. med. J. 1951, ii, 1011.
1. Strean, L.
2. 3. 4. 5.
P., Williams, B. H., Prichard, J. Oral Surg. (in the press). MacKenna, R. M. B. Lancet, 1957, i, 169. Van Scott, E. J., MacCardle, R. C. J. invest. Derm. 1956, 27, 405. Dubovyi, I. Věstn. Vener. Derm. 1955, 2, 22. Aron-Brunetière, R. Sem. Hôp. Paris, 1954, 24, 1513; Ibid. 1956, 32, 2094.
MECHANICAL
FACTORS
PAUL E. POLANI.
A. E. CLAIREAUX.
beneficial effect on the incidence of foetal abnormalities and of the complications of pregnancy and labour-particularly toxaemia, which remains the chief hazard to the life of the expectant mother. T. W. BUCHAN. RECURRENT APHTHOUS STOMATITIS
10 prompts me to otler comment based on observations made in the treatment of this disease. In a paper to be publishedmy colleagues and I di attention to the prevalence of herpetiform lesions and their treatment with gamma-globulin. It is our belief that aphthous ulcers are not caused by herpes virus but by an unknown virus since patients suffering from these ulcers have a low antibody titre against herpes virus while those suffering from herpetic stomatitis frequently have a high antibody titre against the homologOM
SIR,—Your annotation of Aug.
some
antigen. IN ATHEROSCLEROSIS
SiR,-Dr. Robertson and I are grateful to Dr. Hamilton (Aug. 17) for drawing our attention to the proper priority which should have been given to Dr. J. C. Paterson’s name in reference to intimal haemorrhage in our report.! I must confess that in drawing up our list of references I had Dr. Paterson’s later paper before me and carelessly overlooked his earlier one on the same subject. Department of Pathology Royal Victoria Infirmary, Newcastle upon Tyne, 1.
J. B. DUGUID.
STREPTOCOCCAL INFECTIONS AND PREGNANCY SIR,—There is a good deal of evidence on general grounds to incriminate the streptococcus as an infecting agent which might have important effects in early pregnancy, and recently it has been accused of possibly accounting for unexplained foetal abnormalities.2
Since various forms of stress
believed that this blood fraction would contain antibodies this unknown virus. We have treated approximately 50 patients who received varying doses from 3 to 10 ml. Some patients required one injection, while others received additional injections for several days or several weeks. In most instances, prompt recovery was observed. One of these patients suffered from a severe case of Behet’s syndrome and the response was dramatic after many other forms of therapy failed, including we
against
chlortetracycline. Others may wish to try this treatment for a trouble. condition which plagues the patient and humbles the physician and dentist. some
Merck
Sharp & Dohme Research Laboratories, West Point, Pennsylvania, U.S.A.
This
hypothesis is quite rational, significant association at the clinical
and though no level has been demonstrated there is some circumstantial evidence in its favour on the statistical side. When the regional variations of mortality from congenital malformations in the first year of life are compared with the variations of mortality from streptococcal or post-streptococcal diseases, a high level of correlation is obtained. It is of the order + 0.7, t = 3-15. The rates for the decennium 1932-41 are shown in the accompanying table.
(traumatic, physiological, or
emotional) seem to precipitate a crop of aphthous ulcers, we postulated that the resulting increase in endogenous hydro. cortisone might interfere with the immune mechanism. Since gamma-globulin contains antibodies against various viruses.
LYON P. STREAN.
ACNE VULGARIS
SIR,—In. January you very kindly published2a lecture of mine on this subject. There are two items of informa tion which I should now like to add. (1) At the time the lecture was delivered I was not aware of the interesting paper by Van Scott and MacCardle 3 published in the United States, in which they stated that the earliest change in acne is hyper. keratinisation of the excretory duct of the sebaceous gland which results in the deposition of a keratinous plug in the follicular neck. They tentatively suggested that the products of the sebaceous gland may biochemical initiate the hyperkeratosis that leads to the principal morphological lesion of acne." If confirmed their observation is of considerable importance, and their suggestion might well be considered in relation to the work of 4 concerning the increase of 17-ketosteroid excretion through the sebum in acne vulgaris. (2) During the past ten months I have treated more than 35 cases of acne vulgaris both in males and females with tablets each containing 50 i.u. serum-gonadotrophin. The standard dose has been 2 tablets per day but sometimes twice this amount has been given. An important matter in this treatment is that the tablets must be dissolved in the mouth. At first I regarded this therapy. though it was originated by Aron-Brunetière5 with considerable scepticism, and it will require quite a Ion.’ period of observation to determine whether mv first "
Dubovyi
In view of the possibility that the streptococcus is in this and in other disturbances associated
implicated with
pregnancy,3
it
seems
justifiable to
arrange controlled
field trials to test the influence of prophylaxis against streptococcal infection in the early months of pregnancy, on the same lines as prophylaxis against recurrences of rheumatic fever. The new long-acting preparations of penicillin and sulphonamide would be useful here. It would be of great interest to know whether they had a 1. Duguid, J. B., Robertson, W. B. Lancet, 1957, i, 1205. 2. Pleydell, M. J. Ibid, p. 1314. 3. Buchan, T. W. Brit. med. J. 1951, ii, 1011.
1. Strean, L.
2. 3. 4. 5.
P., Williams, B. H., Prichard, J. Oral Surg. (in the press). MacKenna, R. M. B. Lancet, 1957, i, 169. Van Scott, E. J., MacCardle, R. C. J. invest. Derm. 1956, 27, 405. Dubovyi, I. Věstn. Vener. Derm. 1955, 2, 22. Aron-Brunetière, R. Sem. Hôp. Paris, 1954, 24, 1513; Ibid. 1956, 32, 2094.