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SYNTHESIS OF COMPOUND F
42 "
reversals," the mechanism of which is unknown-a akin to that of McLeod,6 who has suggested that the different cultural types of Corynebacterium
hypothesis
diphtherim may be cyclical mutations. An increase in the epidemic type-i meningococcus results from changes in carrier composition and is correlated with the occurrence of meningitis ; but the persistence of a single type in individuals exposed to other types suggests the operation of some general factor in the host. All agree that the relatively high incidence of the disease in the army is due largely to the influx of recruits ; but Aycock and
no evidence that the carrier-rates differed between recruits, seasoned soldiers, and civilians. greatly This susceptibility of recruits to clinical attack is evident only during the first few months of service ; of 3507 cases of meningitis, 78-6% occurred in men with less than six months’ service and 57-6% in men with less than three months’ service. It would therefore not be unreasonable to suppose that Fairbrother was right in attaching importance to fatigue as a contributory factor in attacks among recruits. Fortunately sulphadiazine (and other of the newer sulphonamides) is effective not only in prevention and treatment but also in securing prompt termination of the carrier state. As the result of trials, Aycock and Mueller suggest that the administration of 8 g. of sulphadiazine to recruits upon arrival at the depot would ensure a refractory state throughout
Mueller found
the
period
of
greatest
risk.
AMERICAN HOSPITALS
DESPITE a large Federal construction programme, the U.S.A. is still not within sight of achieving the number of hospital beds it needs. State plans show7 that at the start of 1950 the country had a total of 1,099,493 beds, of which 162,598 were rated as " nonacceptable " ; to replace these and meet the full demand a further 867,833 beds were needed. The upper limits within which the States formulated their estimates were : for general-hospital beds 4-5-5-5 per 1000 population for mental-hospital beds5 per 1000 population ; for tuberculosis beds 2-5 per average annual death in the State over the five-year period 1940-44 ; and for chronic disease 2 beds per 1000 population. The wide discrepancies between different States are reflected in the at the figures for tuberculosis. Whereas Minnesota, " top of the scale, had 2.96 acceptable beds per annual death, Alabama, at the bottom, had only 0-38 ; the national average was 1-43, and in only six States was 2-5 exceeded. (The estimates include beds in hospitals under construction.) These figures do not, of course, indicate the existing special need for more hospitals in the less thickly populated parts. "
TISSUE CULTURE OF HUMAN ENDOMETRIUM THE technique of tissue culture in artificial media has been known for many years, and it is, therefore, surprising that it has not been used more extensively in physiological and pathological research. Randall and his associates 8 seem to be the first to have adopted the technique of Parker 9 and of Medawar 10for the culture of human endometrium in a fluid medium-a method which permits simultaneous study of the effect of the tissue on the medium and of the medium on the tissue. Endometrium is a particularly suitable tissue for this type of work ; it is easily obtained fresh and in quantity by curettage, and it undergoes certain well-defined morphological and functional changes which are only partly understood and whose explanation would be of definite clinical value. 6.
McLeod, J. W. J. Path. Bact. 1950, 62, 137. See Lancet, Dec. 2, 1950, p. 693. 7. Cronin, J. W., Reed, L. S., Baney, A. M. Publ. Hlth Rep., Wash. 1950, 65, 1461. 8. Randall, J. H., Stein, R. J., Stuermer, U. M. Amer. J. Obstet. Gynec. 1950, 60, 711. 9. Parker, R. C. Science, 1937, 85, 292. 10. Medawar, P. B. Quart. J. micr. Sci. 1948, 89, 187.
Randall and his colleagues have already obtained striking results. Thus they found that, whereas proliferative endometrium required, for proper growth, nearly 80% oxygen and 5% carbon dioxide, secretory endometrium survived quite well even under anaerobic conditions. The optimum pH corresponded with these findings : 7-3-7-6 for proliferative endometrium, and 6-7-6.9 for secretory endometrium. Reduction of the temperature greatly prolonged the survival-time of the explanted tissues ; control cultures kept at 37°C began to show evidence of degenerative changes after 10 days, but cultures kept at 4°-5°C were histologically normal On the other hand, at this Ipw even after 35 days. temperature no mitoses were seen in proliferative endometrium, whereas in cultures kept at 25° or 34°C they were numerous. This work opens up a vista of possible on the effects of hormones on the tissue studies-e.g., and its products (which might, incidentally, offer a very neat method of assaying progesterone),; the effects of vitamins, amino-acids, and inorganic ions ; the changes which accompany menstruation ; and the development of inflammatory conditions. some
SYNTHESIS OF COMPOUND F COMPOUND F has been synthesised by research chemists of Messrs. Merck & Co., New Jersey. This, says the New York Tirnes (Dec. 29), was announced at the annual meeting, in Cleveland, of the American Association for the Advancement of Science. Like ’Cortisone’ (Compound E), which was synthesised in the same laboratories, Compound F is made from desoxycholic acid ; the process is completed in 39 stages, compared with 37 for cortisone. Hitherto only small amounts of compound F have been available for trial 1 ; but it is thought to have much the same action as cortisone. The Merck chemists state that, the necessary equipment, substantial amounts of given compound F can be produced within a matter of months. NEW YEAR HONOURS of our profession receiving knightmembers eight hoods,. two are fellows of the Royal Society. Dr. Gordon Holmes has long had so great a name in neurology that a prefix seems almost irrelevant ; and the work on viruses done in Professor Burnet’s institute in Melbourne is known throughout the medical world as that of a mind which can kindle ideas as well as illuminate facts. Mr. Kelsev Fry, with his distinguished record in the Guy’s dental school and as dean of the faculty of dental surgery at the Royal College of Surgeons, has aided the Royal Air Force and the Ministry of Health as consultant. Dr. Selwyn-Clarke, who is appointed K.B.E., is one of the few doctors in the Colonial Service who have become senior administrators : during the war he had the difficult post of director of medical services at HongKong, and his recent efforts, as governor of the Seychelles, to improve the conditions of the people, have likewise called for courage. Also on the Colonial Office list are Dr. F. A. Ibiam (honorary K.B.E.) and Dr. K. A. Abayomi, both of them members of the executive council of Nigeria, and both Scottish graduates. In the Royal Victorian Order, Dr. Daniel Davies and Dr. F. H. Teale are promoted to knighthoods for personal services to the Sovereign and his household. Dr. Davies’s skill as a clinician is based not only on large experience but on patient investigations into the clinical aspects of the pneumonias, anaemias, and dyspepsias ; while Dr. Teale, as former lecturer in bacteriology and head of the immunotherapy department at University College Hospital, has worked on problems of bacterial infection. The-list we print on p. 47 contains also the names of many other men and women who are already honoured in their profession but whose public recognition is none the less welcome to their colleagues.
OF
1. See
Fourman, P., Bartter, F. C., Albright, F., Dempsey, E., Carroll, E., Alexander, J. J. clin. Invest. 1950, 29, 1462.
"
reversals," the mechanism of which is unknown-a akin to that of McLeod,6 who has suggested that the different cultural types of Corynebacterium
hypothesis
diphtherim may be cyclical mutations. An increase in the epidemic type-i meningococcus results from changes in carrier composition and is correlated with the occurrence of meningitis ; but the persistence of a single type in individuals exposed to other types suggests the operation of some general factor in the host. All agree that the relatively high incidence of the disease in the army is due largely to the influx of recruits ; but Aycock and
no evidence that the carrier-rates differed between recruits, seasoned soldiers, and civilians. greatly This susceptibility of recruits to clinical attack is evident only during the first few months of service ; of 3507 cases of meningitis, 78-6% occurred in men with less than six months’ service and 57-6% in men with less than three months’ service. It would therefore not be unreasonable to suppose that Fairbrother was right in attaching importance to fatigue as a contributory factor in attacks among recruits. Fortunately sulphadiazine (and other of the newer sulphonamides) is effective not only in prevention and treatment but also in securing prompt termination of the carrier state. As the result of trials, Aycock and Mueller suggest that the administration of 8 g. of sulphadiazine to recruits upon arrival at the depot would ensure a refractory state throughout
Mueller found
the
period
of
greatest
risk.
AMERICAN HOSPITALS
DESPITE a large Federal construction programme, the U.S.A. is still not within sight of achieving the number of hospital beds it needs. State plans show7 that at the start of 1950 the country had a total of 1,099,493 beds, of which 162,598 were rated as " nonacceptable " ; to replace these and meet the full demand a further 867,833 beds were needed. The upper limits within which the States formulated their estimates were : for general-hospital beds 4-5-5-5 per 1000 population for mental-hospital beds5 per 1000 population ; for tuberculosis beds 2-5 per average annual death in the State over the five-year period 1940-44 ; and for chronic disease 2 beds per 1000 population. The wide discrepancies between different States are reflected in the at the figures for tuberculosis. Whereas Minnesota, " top of the scale, had 2.96 acceptable beds per annual death, Alabama, at the bottom, had only 0-38 ; the national average was 1-43, and in only six States was 2-5 exceeded. (The estimates include beds in hospitals under construction.) These figures do not, of course, indicate the existing special need for more hospitals in the less thickly populated parts. "
TISSUE CULTURE OF HUMAN ENDOMETRIUM THE technique of tissue culture in artificial media has been known for many years, and it is, therefore, surprising that it has not been used more extensively in physiological and pathological research. Randall and his associates 8 seem to be the first to have adopted the technique of Parker 9 and of Medawar 10for the culture of human endometrium in a fluid medium-a method which permits simultaneous study of the effect of the tissue on the medium and of the medium on the tissue. Endometrium is a particularly suitable tissue for this type of work ; it is easily obtained fresh and in quantity by curettage, and it undergoes certain well-defined morphological and functional changes which are only partly understood and whose explanation would be of definite clinical value. 6.
McLeod, J. W. J. Path. Bact. 1950, 62, 137. See Lancet, Dec. 2, 1950, p. 693. 7. Cronin, J. W., Reed, L. S., Baney, A. M. Publ. Hlth Rep., Wash. 1950, 65, 1461. 8. Randall, J. H., Stein, R. J., Stuermer, U. M. Amer. J. Obstet. Gynec. 1950, 60, 711. 9. Parker, R. C. Science, 1937, 85, 292. 10. Medawar, P. B. Quart. J. micr. Sci. 1948, 89, 187.
Randall and his colleagues have already obtained striking results. Thus they found that, whereas proliferative endometrium required, for proper growth, nearly 80% oxygen and 5% carbon dioxide, secretory endometrium survived quite well even under anaerobic conditions. The optimum pH corresponded with these findings : 7-3-7-6 for proliferative endometrium, and 6-7-6.9 for secretory endometrium. Reduction of the temperature greatly prolonged the survival-time of the explanted tissues ; control cultures kept at 37°C began to show evidence of degenerative changes after 10 days, but cultures kept at 4°-5°C were histologically normal On the other hand, at this Ipw even after 35 days. temperature no mitoses were seen in proliferative endometrium, whereas in cultures kept at 25° or 34°C they were numerous. This work opens up a vista of possible on the effects of hormones on the tissue studies-e.g., and its products (which might, incidentally, offer a very neat method of assaying progesterone),; the effects of vitamins, amino-acids, and inorganic ions ; the changes which accompany menstruation ; and the development of inflammatory conditions. some
SYNTHESIS OF COMPOUND F COMPOUND F has been synthesised by research chemists of Messrs. Merck & Co., New Jersey. This, says the New York Tirnes (Dec. 29), was announced at the annual meeting, in Cleveland, of the American Association for the Advancement of Science. Like ’Cortisone’ (Compound E), which was synthesised in the same laboratories, Compound F is made from desoxycholic acid ; the process is completed in 39 stages, compared with 37 for cortisone. Hitherto only small amounts of compound F have been available for trial 1 ; but it is thought to have much the same action as cortisone. The Merck chemists state that, the necessary equipment, substantial amounts of given compound F can be produced within a matter of months. NEW YEAR HONOURS of our profession receiving knightmembers eight hoods,. two are fellows of the Royal Society. Dr. Gordon Holmes has long had so great a name in neurology that a prefix seems almost irrelevant ; and the work on viruses done in Professor Burnet’s institute in Melbourne is known throughout the medical world as that of a mind which can kindle ideas as well as illuminate facts. Mr. Kelsev Fry, with his distinguished record in the Guy’s dental school and as dean of the faculty of dental surgery at the Royal College of Surgeons, has aided the Royal Air Force and the Ministry of Health as consultant. Dr. Selwyn-Clarke, who is appointed K.B.E., is one of the few doctors in the Colonial Service who have become senior administrators : during the war he had the difficult post of director of medical services at HongKong, and his recent efforts, as governor of the Seychelles, to improve the conditions of the people, have likewise called for courage. Also on the Colonial Office list are Dr. F. A. Ibiam (honorary K.B.E.) and Dr. K. A. Abayomi, both of them members of the executive council of Nigeria, and both Scottish graduates. In the Royal Victorian Order, Dr. Daniel Davies and Dr. F. H. Teale are promoted to knighthoods for personal services to the Sovereign and his household. Dr. Davies’s skill as a clinician is based not only on large experience but on patient investigations into the clinical aspects of the pneumonias, anaemias, and dyspepsias ; while Dr. Teale, as former lecturer in bacteriology and head of the immunotherapy department at University College Hospital, has worked on problems of bacterial infection. The-list we print on p. 47 contains also the names of many other men and women who are already honoured in their profession but whose public recognition is none the less welcome to their colleagues.
OF
1. See
Fourman, P., Bartter, F. C., Albright, F., Dempsey, E., Carroll, E., Alexander, J. J. clin. Invest. 1950, 29, 1462.
"