Showing papers in "JAMA Internal Medicine in 1961"

Personal Knowledge: Towards a Post-Critical Philosophy

Abstract: The Study of Man. By Michael Polanyi. Price, $1.75. Pp. 102. University of Chicago Press, 5750 Ellis Ave., Chicago 37, 1959. One subtitle to Polanyi's challenging and fascinating book might be The Evolution and Natural History of Error , for Polanyi is at pains to expunge what he believes to be the false notion contained in the contemporary view of science which treats it as an object and basically impersonal discipline. According to Polanyi not only is this a radical and important error, but it is harmful to the objectives of science itself. Another subtitle could be Farewell to Detachment , for in place of cold objectivity he develops the idea that science is necessarily intensely personal. It is a human endeavor and human point of view which cannot be divorced from nor uprooted out of the human matrix from which it arises and in which it works. For a good while

Tularemia vaccine study. II. Respiratory challenge.

Abstract: Previous studies from these laboratories demonstrated that man can readily be infected by intracutaneous inoculation with approximately 10 Pasteurella tularensis organisms (SCHU S4 strain). 1 Prior vaccination with killed Foshay vaccine did not prevent local lesions, but did reduce the incidence of systemic manifestations of infection. Review of accidental laboratory infection indicates that the respiratory route may serve as a portal of entry. 2 Experimental respiratory infections can easily be induced in both vaccinated and nonvaccinated monkeys, and response to therapy is good. 3 This present report describes the response to respiratory challenge with P. tularensis of nonvaccinated volunteers and of volunteers who received either killed vaccine or a viable attenuated vaccine. Materials and Methods Volunteers were inmates of the Ohio State Penitentiary, 21 to 35 years of age. Criteria for selection and conditions of volunteering have been described. 1 Vaccination with Foshay killed tularemia vaccine was conducted as previously

Epilepsy and Related Disorders

Abstract: This work is published in two volumes with numerous illustrations and tables. The author has an engaging style, and the apostrophe, simile, and pathetic fallacy are woven into the text in an entertaining manner. It would make instructive reading for the stilted "subject-predicate" school of medical writers. The opening chapters deal with the early writings on epilepsy and explore the evolving concepts of causation. The various convulsive disorders are then classified and described. There is a chapter on the "Borderlands of Epilepsy" which includes migraine, syncope, carotid sinus syndrome, narcolepsy, hysteria, vertigo, and sleep disorders—the relationship of these to epilepsy it extremely tenuous. Other chapters consider sources of seizures, genetics of epilepsy, acquired epilepsy, electrobiology, and therapeutics. There is an interesting chapter on epileptics of worth and fame. The final chapters are a sympathetic look at the social, emotional, and legal problems of this disorder. The appraisal of the book

The Two Cultures and The Scientific Revolution

Abstract: Last year's Rede Lecture at Cambridge by C. P. Snow is now available in a slim, thoughtful, and disturbing volume entitled The Two Cultures and The Scientific Revolution . It runs a mere 58 pages of direct, insistent, pellucid prose and can be read in one hour. Since it takes so little time to courageously tackle two problems vital to scientists, and since it is modestly priced, this unimposing book may well be the greatest literary bargain of an inflated publishing age. The "two cultures" in the title are the modern culture of the scientific intellectual and the traditional culture of the literary intellectual. With a foot in each cultural camp, C. P. Snow comes uniquely armed to the fray. He states his own qualifications: "by training I was a scientist; by vocation I was a writer." More specifically, Charles Percy Snow, the scientist, won his M. A. in physics in

Tularemia Vaccine Study: I. Intracutaneous Challenge

Abstract: The frequency with which Pasteurella tularensis infects hunters of rabbits and laboratory workers studying this microorganism makes vaccination of these persons desirable. However, the protective value of available nonviable vaccines is not certain. Studies on this point have been conducted by Foshay et al. 1 and Kadull et al. 2 The ideal method of evaluating a vaccine intended for protection of humans is to challenge volunteers, both vaccinated and nonvaccinated, with a reproducible known infective dose of the disease-producing agent. A study in a small vaccinated group challenged by a known infective dose can provide more specific information in a shorter time than by assembling a much larger number in a study in which vaccinated persons are "exposed" accidentally in varying degree or not at all. Pasteurella tularensis offers certain advantages in such a critical study employing human challenge with viable microorganisms. A broad base of preliminary experience is provided

"Lifespan" of liver cells. Autoradio-graphic study using tritiated thymidine in normal, cirrhotic, and partially hepatectomized rats.

Abstract: Little information is available concerning the lifespan of liver cells in the normal and diseased liver. This is a study of the length of time that newly formed hepatic nuclei containing tritium (H 3 )-labeled deoxyribonucleic acid (DNA) remain in the liver in normal rats and mice, and in rats with fatty, cirrhotic, and partially hepatectomized liver. The method was as follows. It has been observed that thymidine is a specific precursor of DNA, 1 which is considered to be relatively stable until a cell prepares for division, at which time the cell synthesizes additional DNA. 2 The half-life of tritium is 12.5 years, 3 and that of the rat is approximately 3 years, 4 so that tritiated thymidine (H 3 -thymidine) incorporated into cell nuclei should identify those nuclei for the life of the animal, until the cells divide further, diluting out their labeled DNA, or until the cells

McGraw-Hill Encyclopedia of Science and Technology

Abstract: This momentous 15-volume work with its entirely new, lucid, and unique format should prove of remarkable value to all physicians. With its 7,200 profusely illustrated articles by more than 2,100 contributors, including a number of Nobel Laureates and other eminent scientists, this encyclopedia should stand as one of the most useful and usable publications for the dissemination of scientific information in many years. The books have been edited to be "a work of, not about, science." Unlike other encyclopedias it contains almost no historical or biographical discussions, but to allow for longer essays consists entirely of modern factual presentations of scientific subjects. The articles are written to be understandable by scientists outside of their field of specialization. For example the numerous articles on physics are written for the nonphysicist, but still are more comprehensive and much more readable than expositions in general encyclopedias. One or more illustrations or diagrams appear

Convalescence from influenza. A study of the psychological and clinical determinants.

Abstract: In a recent study1of convalescence from acute brucellosis the findings strongly supported the view that delay or failure in symptomatic recovery from that disorder is critically dependent upon the emotional state or attitude of the person. While no objective clinical or laboratory findings differentiated those persons who recovered quickly and completely from those who retained symptoms for a long period of time (chronic brucellosis), there were striking differences between these two groups in terms of psychological adjustment and life situation concurrent with the acute phase of the infection. The evidence pointed to the importance of depression particularly in retarding symptomatic recovery from the illness. The study of convalescence of patients with brucellosis was done retrospectively in that the persons were investigated medically and psychologically some time after the acute illness had been contracted. We felt reasonably assured that certain features of the study enabled us to differentiate between

Tritiated digoxin studies in human subjects.

Abstract: A number of publications have appeared in recent years regarding the metabolic behavior, fate, and excretion of C14-labeled digitoxin.1-8Labeled digoxin has received little attention.9-11The preparation of a C14-labeled compound has not been practical because of the expense and uncertainty of the digoxin content of digitalis glycosides. The possibility of a tritium (H3) label was explored and was found to be both cheap and practical utilizing the Wilzbach hydrogen exchange method. The present study was undertaken to study the serum levels, absorption, and excretion of tritium-labeled digoxin*in human subjects after singledose oral digitalization. Most of the metabolic studies of unlabeled digoxin12,13have revealed the presence of unchanged digoxin and metabolite "B" in the urine of both rats and humans. Brown and Wright14reported the presence of metabolite "F" in the tissue of rats. Metabolite "B" has not been demonstrated

Bronchotracheal response in human influenza. Type A, Asian strain, as studied by light and electron microscopic examination of bronchoscopic biopsies.

Abstract: In contrast to the ubiquity of human influenzal infection, documentation of the accompanying characteristic histopathologic alterations is limited. This is largely due to the generally nonfatal course of influenza in man. Further difficulties arise from the almost constant presence of complicating bacterial infection in fatal cases. Such circumstances are indeed unfortunate in the light of current limitations in the prevention and treatment of influenza. For these reasons, a major objective of our multidisciplinary investigation 1-3 of pandemic influenza (Type A, Asian Strain) was the histologic study of the tracheobronchial tree in influenza uncomplicated by bacterial infection. To our knowledge this is the first description as studied by bronchoscopic biopsy of the mucosal response in humans to uncomplicated influenza. Material and Methods Initially, bronchoscopy and tracheobronchial mucosal biopsy were performed from 1 to 7 days after the acute onset of symptoms in 12 young adults with apparent uncomplicated influenza. Subsequent studies

Summerhill: A Radical Approach to Child Rearing

Abstract: Here is a book designed to set us free; free from fear, shame, and guilt, the generators of so much malevolence and mayhem, and of the misbegotten man whom we seem to find all around us. Alexander Neill must be one of the unique schoolmasters of all time. Starting work toward the end of the nineteenth century, at the age of fourteen, he fortunately (for us) failed respectively as a clerk and a draper's assistant. He then became a student teacher under the aegis of his father and later passed a competitive examination to enter a teacher's training college. He studied Latin and Greek and specialized in English, eventually graduating with honors in English literature from Edinburgh University. He experimented with journalism and book publishing before founding (in 1921) the amazing school called Summerhill in the village of Leiston in Suffolk, England. Here children between the ages of five and

Amyloidosis in familial Mediterranean fever. An independent genetically determined character.

Abstract: Renal disease occurs frequently in familial Mediterranean fever (F.M.F.) and is of grave prognostic significance. Mamou and Cattan, the first to recognize this, published detailed case histories and noted the familial pattern of occurrence.1In 1952 we diagnosed amyloidosis as the cause of nephrotic syndrome in one of our patients, and autopsy confirmed the diagnosis. Since other cases of F.M.F. with signs of renal disease were already under observation, we considered the possibility of an inherent relationship between F.M.F. and amyloidosis.2,3Since then, all autopsied cases of F.M.F. reported in the literature have disclosed amyloidosis,4-6further strengthening this possibility. If we consider that in F.M.F. amyloidosis appears, most unusually and almost uniquely, as a part of a genetic disorder,7-9it seems important to report our experience in a series of cases in various stages of renal disease who have been observed over many years. Material Our

Observations on digitalis intoxication.

Abstract: Since Withering's oft-quoted observations on digitalis intoxication much has been written. While the exact frequency of cardiotoxicity has not been determined, the increasing number of case reports appearing in the literature suggest that this complication of digitalis therapy is of sufficient magnitude to demand repeated, careful examination of all digitalized patients, and, perhaps, even to question the need for continued use of the drug. Many previous studies on digitalis intoxication have been retrospective. 1-9 Whereas much valuable information has resulted from this approach, such reports have many and obvious shortcomings. 10 In two planned studies 11,12 the incidence of digitalis toxicity was considerably higher than might have been suspected from less well-designed observations. Because of this, we have studied all patients developing digitalis intoxication in our hospital on a day-to-day basis for a 12-month period (July 1, 1958, to June 30, 1959). Methods and Materials The Veterans Administration Hospital in

Primary Systemic Amyloidosis and Myeloma: Discussion of Relationship and Review of 81 Cases

Abstract: "Primary" systemic amyloidosis is at times the root of an obscure problem. Its cause is unknown but has for some years been regarded as closely related to multiple myeloma. This close relationship and the view that both are primary plasmocytic diseases, perhaps varying aspects of the same disease, as been reemphasized lately.1,2In the present review of systemic amyloidosis, bone-marrow cytologic findings and other data were studied with this possibility in mind. "Primary" systemic amyloidosis, for purposes of this study, was regarded as a condition associated with deposition of a homogeneous, amorphous, proteinaceous material that stains pink with hematoxylin and eosin, metachromatically with methyl violet, red with Congo red, and yellow or pink with van Gieson stain, and that occurs in the absence of preexisting or coexisting etiologic disease other than myeloma. Review of Literature Perhaps the first report of primary amyloidosis in the literature was made by Wilks

The biochemical lesion in ketosis.

Abstract: Much information has come to light in recent years which bears on the problem of why ketone bodies accumulate in the mammalian body under certain conditions. I propose to discuss in this lecture observations which lead to the concept that ketosis is a disorder of the regulation of metabolic processes rather than an insufficiency of certain enzymes or of key metabolites. Let me first recall the main biochemical facts concerning the accumulation of ketone bodies. It is now firmly established that the bulk of the ketone bodies arises by condensation of acetate which reacts in the form of acetyl coenzyme A (Scheme 1). It is also firmly established that all foodstuffs—not only fats but also carbohydrates and proteins—yield acetyl coenzyme A when they are burned in the body, and are therefore potential sources of ketone bodies. Acetyl coenzyme A can enter many metabolic reactions, but quantitatively the most important one

Androgens and erythropoiesis. I. Preliminary clinical observations.

Abstract: Repeated observations have demonstrated that adult men have higher values than women for red blood cell count, hemoglobin, and hematocrit.1,2More recently it has been shown that the total red cell volume of the human male exceeds that of the female. These differences are apparently not caused solely by iron deficiency, pregnancy, or menstrual blood loss.3Such statistically valid sexual differences, the changes of which are most pronounced during the period of greatest sexual activity,2suggest that erythropoiesis and the elaboration of sex hormones are intimately related. Further correlations of blood volume with lean body mass measurements will be helpful in defining such influences. These phenomena have also been reported in many species of mammals and in fowl. Animal experimental work has been extensive but difficult to interpret. The removal of many endocrine glands induces an anemia which disappears when the lacking hormone is supplied.4Vollmer

Acute pancreatitis associated with steroid therapy.

Abstract: It has been clearly demonstrated that rabbits given high doses of cortisone develop pathologic changes in the pancreatic acini as well as focal fat necrosis and lesions characteristic of focal pancreatitis. 1,2 On the other hand, surprisingly few cases of pancreatitis developing in patients receiving corticotropin (ACTH) or adrenal steroids have been reported. 3-6 The purpose of this paper is to describe 6 patients in whom the clinical and pathological evidence suggested steroid therapy had induced acute pancreatitis. Report of Cases Case 1.— This 42-year-old white man was in good health until March, 1956, when he developed malaise, persistent frontal headache, and daily fever. Extensive bacteriological, serological, and x-ray studies were done. None was revealing. Broad spectrum antibiotics did not alter the fever pattern. A clinical diagnosis of disseminated lupus erythematosis was made, and in April, 40 units of corticotropin and 20 mg. of prednisone per day were begun (Fig.

Neurologic complications of acute uremia.

Abstract: Introduction Attempts to evaluate the effects of uremia on the nervous system must separate those aspects secondary to the uremia from those attributable to the underlying disorder. Many diseases which affect the kidneys also directly affect the nervous system. In an attempt to distinguish the effects of uremia on the nervous system, a series of patients with acute uremia was studied. Cases of lupus erythematosus, sclerodema, polyarteritis nodosa, multiple myeloma, polycystic disease, and severe hypertension with renal involvement were excluded from consideration. Included in the category of acute renal failure were all cases in which there was no evidence of renal disease antedating the present illness and in which an acute insult could be postulated. Thirteen consecutive patients with acute anuria were seen in neurological consultation after admission to the Peter Bent Brigham Hospital. They were examined daily until discharged or until death. Specific attention was directed to the mental

Association of Cushing's Syndrome and Neoplastic Disease: Observations in 232 Cases of Cushing's Syndrome and Review of Literature

Abstract: The association of Cushing's syndrome and neoplastic disease has occurred with sufficient frequency to suggest something more than a coincidental relationship. Having excluded pituitary and adrenocortical tumors, we were able to find reports of 58 cases in which neoplasms of various other kinds occurred in patients with Cushing's syndrome. This group comprised 18 thymomas, 1-15 22 bronchogenic carcinomas, 16-34 8 pancreatic carcinomas (5 acinar and 3 islet cell), 2,35-41 and 10 miscellaneous tumors 42-51 ; the 10 miscellaneous neoplasms included 3 tumors of the central nervous system, a sympathoblastoma, 2 cases of carcinoma of the thyroid, and 1 case each of carcinoma of the testicle, ovary, prostate, and esophagus. With one exception, 51 the association was a simultaneous one. In addition, there have been several instances in which both adrenocortical and adrenal medullary hyperfunction were thought to have occurred in the same patient, 52-64 although in most of these cases the supporting

A Study of Pulmonary Embolism: Part I. A Clinicopathological Investigation of 100 Cases of Massive Embolism of the Pulmonary Artery; Diagnosis by Physical Signs and Differentiation from Acute Myocardial Infarction

Abstract: No condition is less often diagnosed correctly than massive pulmonary embolism. The purpose of this communication is to show that (1) a high percentage of diagnotic errors is made in it, (2) that there are definite reasons for these mistakes, and (3) that there appears to be a possibility of increasing general diagnostic accuracy by systematic examination of the patient for certain physical signs. Until Herrick's 1 classical description of acute myocardial infarction in 1912, sudden deaths were frequently and often erroneously attributed to massive pulmonary embolism. In recent years the pendulum has swung in the other direction. Sudden deaths occurring at the present time are prone to be ascribed to acute myocardial infarction. It is true that in any large series of sudden deaths, as Hamman 2 has pointed out, 40% will be found to have myocardial infarcts, and only 5% pulmonary emboli. The odds, therefore, are 8 to

Aortic stenosis and unexplained gastrointestinal bleeding.

Abstract: Recently, we have encountered a group of patients with aortic stenosis who present with recurrent, often massive, unexplained gastrointestinal hemorrhage. Our attention was directed to this association when 4 such patients were admitted to the Massachusetts General Hospital during a single 2-week interval. A study of this clinical association was undertaken by analysis of a large group of consecutive patients with gastrointestinal bleeding. Patients with obvious sources for bleeding were analyzed for associated aortic valvular disease and, in addition, patients with aortic stenosis proven at autopsy or occasionally left heart catheterization were studied with respect to history of gastro-intestinal hemorrhage. Heyde 1 and Schwartz 2 in 1958 have called attention previously to the association of gastrointestinal bleeding and aortic stenosis, but no other references to this were found in a review of the literature. Plan of Study The records of 1,782 consecutive patients, diagnosed as having gastrointestinal bleeding and admitted

The Milk-Alkali Syndrome

Abstract: I. The Diversity of Clinical Manifestations Eleven years ago Burnett and his associates 1 described a syndrome occurring in patients who had ingested milk and absorbable alkali for prolonged periods of time. The characteristic features were hypercalcemia without hypercalciuria or hypophosphatemia, mild alkalosis, a normal serum alkaline phosphatase, severe renal insufficiency with azotemia, and calcinosis manifested chiefly by the presence of band keratopathy. Improvement followed restriction of the intake of milk and absorbable alkali. In the intervening decade it has become apparent that there are many variants in the "milk-alkali syndrome," as it has now come to be known. 2-20 It is the purpose of this paper to present 4 cases illustrating the variability of manifestations which may result from excessive intake of milk and to stress 3 facts: 1. Hypercalcemia may continue for many months after cessation of a large calcium intake; 2. Moderate impairment in renal function with

A Study of Pulmonary Embolism: Part II. The Mechanism of Death; Based on a Clinicopathological Investigation of 100 Cases of Massive and 285 Cases of Minor Embolism of the Pulmonary Artery

Abstract: An obstructive embolus in the main stem or in one of the two principal branches of the pulmonary artery almost invariably causes sudden death as has been shown in the 100 cases of massive pulmonary embolism described in Part I. A large coiled-up embolus originating in a femoral vein produces only minimal pathologic changes in the lungs, such as edema and atelectasis. By contrast, when a medium-sized artery is blocked, characteristic changes take place in the lung parenchyma supplied by this vessel. As a result of the stoppage of blood flow, the alveoli and capillaries become markedly distended with red blood cells, and a red infarct forms. Pulmonary infarcts are seldom white or anemic but are almost always hemorrhagic, because of the rapid anastomosis which develops between the pulmonary and bronchial vessels, when obstruction occurs in the former. Later if the patient recovers the red cells degenerate, and the alveolar

Clinical Chemistry: Principles and Procedures

Abstract: This edition has been prepared as a basic text for beginning students in clinical chemistry and for laboratory technicians with little or no formal training. In the first section of the book, the author has attempted to provide a very brief and simplified source of miscellaneous information relevant to basic chemistry and laboratory principles. As do other authors who present this limited type of review section, Annino encountered problems of content, organization, and continuity of the discussions; but, in general, the product adequately suited his purpose. The major portion of the book is concerned with methods. The author has carefully selected those procedures which have been employed by many experienced chemists and that comprehend a variety of the techniques used by laboratory personnel. It is emphasized that "this text is not intended as a reference book of methods." In presenting a particular test, Annino generally discusses what should be considered

Genetics of Familial Mediterranean Fever (FMF): A Disorder with Recessive Inheritance in Non-Ashkenazi Jews and Armenians

Abstract: Introduction It has been stated in former papers1,2that Familial Mediterranean Fever (FMF) is a genetic disorder practically restricted to people from the wider Mediterranean area. This being of basic importance in the understanding of the disease and in research as to its nature, it is pertinent to report the results of a country-wide investigation which establishes the genetic behavior and the ethnic distribution of FMF within the popution of Israel. The conditions in Israel are particularly favorable for a project of this sort. The present population is composed of ethnic groups who for centuries were separated from one another and married each within the group. Genetic peculiarities, therefore, should manifest themselves distinctly. In addition, reliable population statistics are available from which the countries of origin can be calculated,3and the small total population makes a general survey a feasible undertaking. Methods and Material Our case material has

Cryopathies: a review. Classification; diagnostic and therapeutic considerations.

Abstract: In recent years certain disorders associated with marked intolerance to cold have received considerable attention. There is no generally accepted terminology or classification of cold sensitivity syndromes, and furthermore, cold intolerance has not been previously considered as a clinical entity. Following exposure to cold, affected patients commonly exhibit several of the followingsigns and symptoms:cyanosis, numbness, Raynaud's phenomenon; urticaria, purpura of skin and mucous membranes; vascular occlusions resulting in visual disturbances, deafness, or pulmonary infarctions; ulceration, necrosis, gangrene; hemolytic anemia, hemoglobinuria; rigors and fever.2,3,66,184Seasonal exacerbations and remissions are characteristic. The termcryopathyis suggested as an all-inclusive term for these clinical conditions.1,184Presently available diagnostic and therapeutic methods make possible a reasonably precise differentiation between the various entities. The following etiologicalclassification of cryopathiesis suggested: Cryoglobulinemias Cryofibrinogenemias Paroxysmal cold hemoglobinurias: Cold agglutinin syndrome Cold hemolysin syndrome Cold intolerance in

Aldosteronism and Hypertension: Primary Aldosteronism Versus Hypertensive Disease with Secondary Aldosteronism

Abstract: This presentation has 2 major objectives. The first is to present an over-all analysis of the findings and experience of those who have studied primary aldosteronism with the hope that it will serve as a basis for improvement of diagnostic criteria of this curable form of hypertension. The second is to define and perhaps clarify current problems in distinguishing primary aldosteronism from renal, malignant, and essential hypertension. The Figure shows a few data over 5 years on the first patient recognized as having primary aldosteronism.1-4Of note are a 14.8 gm. right adrenal adenoma, very high values for aldosterone in the preoperative period withmildhypertension, the quick reversal of the abnormal electrolyte pattern of the serum in the postoperative period, the elevated levels of serum potassium 3 months after operation suggesting aldosterone deficiency, and finally, 5 years later, the maintenance of normal blood pressure, normal serum electrolytes, and

Prolonged Hyperventilation in Man: Associated Electrolyte Changes and Subjective Symptoms

Abstract: There are a number of reports concerning the physiological effects of voluntary hyperventilation in the human1-7Hyperventilation has been said to be an extremely fatiguing activity Accordingly, most of the previous studies on voluntary hyperventilators have been for relatively short periods of time The purpose of this report is to point out our observations in 4 volunteers who hyperventilated for periods up to 4 hours and longer Observations were made regarding (1) subjective symptoms and (2) changes in electrolytes The fall of serum inorganic phosphorus concentration was so marked in our cases that we felt justified in reemphasizing this observation Procedure By means of the Beckman Spinco infrared carbon dioxide analyzer, the alveolar CO2was monitored via an intranasal catheter and maintained in the range of 20% to 25% (or approximately one-half the normal level for these subjects) The rate and amplitude of respiration were constantly adjusted to

Diagnosis of liver disease by radioisotope scanning.

Abstract: In 1950 Cassen and his associates described an instrument that could measure the spatial distribution of radioactive iodine in the thyroid gland.1Since that time, several different scanning devices have been developed and applied to problems in medical diagnosis.2-5 Advances have been chiefly along 3 lines: (1) the development of improved radiation detection equipment; (2) the production of radiopharmaceutical compounds that concentrate in organs, such as the liver and kidneys; and (3) a more complete understanding of the factors necessary to obtain good scanning images. It is now possible to construct scanning devices capable of detecting small differences in the spatial distribution of radioactivity in internal organs and presenting the data in a form that can be readily interpreted. The photoscanner developed at the Johns Hopkins Hospital is used for numerous scanning procedures—for the detection of brain tumors,6for thyroid scanning, for the differentiation of pericardial effusion

Studies of nicotinic acid use in hypercholesteremia. Changes in hepatic function, carbohydrate tolerance, and uric acid metabolism.

Abstract: Numerous reports have verified reduction of serum cholesterol levels in human hypercholesterolemia by large doses of nicotinic acid (3 to 6 gm. daily). In fact, it has become increasingly apparent that this is the most effective chemotherapeutic agent presently available for this purpose, as indicated by its prominent mention by several participants in the recent symposium onThe Significance of Lowered Cholesterol Levelspublished by the AMA Council of Foods and Nutrition.1The program's apparent safety has been mentioned by most investigators, but almost without exception the statements have been based on observations covering periods of one year or less. Our first 2 years of experience (1956-1958) failed to show any significant alterations in hematologic studies, routine urinalyses, blood glucose, or nonprotein nitrogen levels, or in a battery of liver function tests. Needle biopsies of the liver in 17 patients after more than one year of treatment were reviewed