The Blood Concentration and Excretion of Sulfadiazine

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AMERICAN ,JOURNAL

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OBSTE'l'RICS AND GYNECOI,OGY

the uterus. 'rhese are (1) edema of the endometrium; (2) formation of an em· bryo chamber; (:!) Rwelling of the glamh•: (.f) condenRation of the ~troma aromul the embryo chamber, leading to deYPlopment of the tleeidua eompaeta. 'l'hesP reactions are evoked by thf' emhr;nJ Bf>riatim antl inrlependently of each other . except that reactions (3) and (4) ~tart Rimultaneously. At one time or another while the embryo is Iring in the uteru~ nnin1planteactions may have begun, go on unche<•ked l>y ;;;ul>sequent renetionR whieh would have happened if the embryo were alive. A<·cording to the time of death of the embryo, the result ma;~r be a very intenBe edema, an ahuorrnallr larg·;1 Pmhr.\'O chamber, or a decidual reartion of pathologic character. (h;ORG!•i W. CORNER.

Nelson, Edward W., Jones, J. R., and Collins, Conrad G.: Pelvic Thromophlebitis -A Study of the Etiologic Factors From a Statistical Standpoint, New Or· Jeans M. and S. ,T, 95: 375, Hl43. A group of forty·one cases of pelvic thrombophlebitis proved a.t autopsy or at the time of operation are reported. The gravity of this disease is emphasized and the etiologic factors contributing to its development are analyzed. Deliver~·, abortion, operation and irradiation are the most frequent precurHors. Hepeated aerobic and anaerobic blood cultures are necessary to establish tht> etiology. Staphylococcus aureus and nonhemolytic streptococcus were the most frequent offenders. The uterine vein~, iliae veins, ovarian veins and inferior \·ena eava were involved in the order named. Pulmonary infarction is extremely (•ommon, and frequent x-ray of the chest in patients running a septic course with no clinical signs of pelvic thrombophlebitis will often establish the diagno~i~ when pelvic examination demon~trates no pathology. Early treatment will reduce th<' 50 per cent mortality associated vl'i.th this disease and Iig'ation of tbfl inferior vena cava is recommended a~ the treatment of choice. WILLIAM BICKERS.

Ryan, John D., Bauman, Eli, Mulholland, John H.: The Blood Concentration and Excretion of Sulfadiazine, J. A. M. A. 119: 484, 1!142. The authors describe the findings of blood and urinary concentrationR of sulfadiazine when placed in the peritoneal eavit)·. The concentration of sulfadiazine in the blood following the intraperitoneal administration of the orug rises fairly rapidly and remains elevated for a eonsiderable period of time depending upon the amount of the drug administered. With ten, twenty and twenty-five gmm doses the effective blood levels persist Jor 48, 7!.l, and 96 homs respectively. Tlw drug need not, therefore, be administered by any other route for the first 2 to + days. The powder is readily absorbed from the peritoneum. HR ab~orption i~ somewhat slower than that of sulfanilamide, and, therefore, the authors feel it is better than loeal intraperitoneal implantation. There were no postoperative complications and no toxic manifestations were observed in any of thfl ease~ studied. WILLIAM BERMAN.

Ivy, A. C., Greengard, H., Stein, I. F., Jr., Grodina, F. S., and Dutton, D. F.: The E:ffect of Various Blood Substitutes in Resuscitation After an Otherwise Fatal Hemorrhage, Surg., Gynec. & Obst. 76: S5, 1943. '!.'he authors studied the use of val'ious blood substitutes in the case of severe hemorrhage in dogs. 'l'he control group consisted of fifty animals losing from 45 to 70 per cent of the blood volume. 'l'he mortality was 84 per cent.