Necrotising fasciitis caused by dental infection

A case of necrotising fasciitis caused by dental infection is presented, which resulted in severe mutilation but the patient survived. The diagnosis and management of this condition is discussed.

Problems in the early recognition of hip dysplasia

Ten children who had clinically stable hips at birth were radiographed at one month because they had factors predisposing to hip dislocation. In all cases one or both hips gave rise to a suspicion of dysplasia, though clinical abnormalities were slow to appear. Four of these hips subsequently dislocated. We believe that infants with late presentation of acetabular dysplasia and clinical abnormality belong to a different aetiological group from those with neonatal instability due to ligamentous laxity. The significance of this differentiation is that some infants presenting late have only recently dislocated, and the diagnosis has not necessarily been "missed" at neonatal examination.

Behavioural adaptations of birds to environments where evaporation is high and water is in short supply

1. Behaviour that reduces the heat load or evaporation experienced by birds living in arid areas is reviewed. Many species have evolved hunting behaviour that enables them to remain inactive during the hottest parts of the day and thus greatly reduce the amount of metabolic heat that they need to dissipate. Flights to water are made at low ambient temperatures, either early in the morning or late in the evening. Fighting is rare in many species of desert birds, avoiding the excess generation of heat by this activity. Many arid zone birds maintain long-lasting pair bonds, avoiding the necessity for active, elaborate display before breeding and again reducing activity. 2. The observations on nomadism are discussed. No unifying principles that might control the behaviour of birds seeking widely separated areas of abundance of food have yet emerged. 3. Some species have evolved mechanisms, embodied in behavioural characteristics, that ensure that the eggs and chicks are sheltered from high temperatures and are provided with adequate moisture. 4. Birds have evolved many different kinds of behavioural adaptation to arid zones and representatives from many avian families live there, apparently successfully.

Control of renal tubular phosphate reabsorption by parathyroid hormone in man

1. The maximum tubular reabsorption capacity for phosphate relative to glomerular filtration rate (Tm,P/GFR) was found to range from 0·8 to 1·5 mmol/l in 32 normal fasting subjects. In 14 patients with primary hyperparathyroidism and five patients with hyperparathyroidism secondary to vitamin D deficiency or malabsorption values ranged from 0·2 to 0·8 mmol/l.

2. Plasma parathyroid hormone concentrations measured by an immunoradiometric technique ranged from <0·15 to 0·9 ng/ml in the normal subjects and from 0·5 to 10 ng/ml in the patients with hyperparathyroidism. There was no correlation, however, between plasma parathyroid hormone and Tm,P/GFR in either normal or abnormal groups.

3. Plasma parathyroid hormone was lower in 11 out of 13 patients with primary hyperparathyroidism 3 or 4 weeks after tumour removal than immediately before the operation. In all cases there was a rise in Tm,P/GFR, though not all values were normalized.

4. Changes in plasma parathyroid hormone, Tm,P/GFR and plasma and urinary cyclic AMP concentrations were measured during infusion of bovine parathyroid hormone into normal fasting subjects. Phosphate reabsorption fell markedly in response to low doses of parathyroid hormone (0·5 i.u. h−1 kg−1), higher doses (4 i.u. h−1 kg−1) producing little additional change in Tm,P/GFR despite large changes in cyclic AMP excretion. At the highest doses used (8 i.u. h−1 kg−1) apparent saturation of the renal adenylate cyclase occurred. During an infusion of hormone, 0·25 i.u. h−1 kg−1 over 3 h, a fall in Tm,P/GFR was recorded at concentrations of immunoreactive parathyroid hormone within the normal range for endogeneous hormone. At such concentrations it was not possible to detect significant changes in either plasma or urine cyclic AMP.

5. It is concluded that parathyroid hormone is an important regulator of renal phosphate handling under normal physiological conditions. Such a regulatory process has been implicated in the control of vitamin D metabolism.

Two-site assay of bovine parathyroid hormone

A two-site assay has been developed for bovine PTH. This technique involves reaction of the antigen with two antibody molecules with the purpose of increasing specificity. In paratice the hormone was extracted form plasma samples on to plastic tubes coated with antibody specific for PTH (1-34). Uptake was then measured using 125I-labelled antibodies specific for PTH (53-84). In this way a sensitive assay was obtained for PTH (1-84) which did not recognize molecular fragments. This technique was used in conjunction with immunoradiometric assays specific for either NH2-terminal (1-34) or CO2H-terminal (53-84) molecular fragments to study the clearance of infused PTH in the cow. Preliminary results support the hypothesis that the intact molecule is rapidly degraded in the peripheral circulation with the preferential disappearance of an NH2-terminal fragment. Studies on endogenous secretion during calcium and EDTA infusions indicated that there was little intact hormone present at the times when CO2H-terminal immunoreactivity was readily measured.

Effect of poliovirus on deoxyribonucleic acid synthesis in HeLa cells

Ackermann, W. W. (University of Michigan, Ann Arbor), D. C. Cox, H. Kurtz, C. D. Powers, and S. J. Davies. Effect of poliovirus on deoxyribonucleic acid synthesis in HeLa cells. J. Bacteriol. 91:1943-1952. 1966.-Both poliovirus and arginine stimulated deoxyribonucleic acid (DNA) synthesis in cultures of HeLa cells which were preconditioned by incubation in a medium deficient in arginine. However, the number of cells producing DNA was unaffected. DNA synthesis in such preconditioned cells was 10 to 20% of the maximal value obtained with a full complement of amino acids. Inhibition of DNA synthesis was produced in these cultures either by increasing the multiplicity of exposure above 40 plaque-forming units of virus per cell or by increasing the concentration of the deficient amino acid at the time of virus addition. Inhibition of DNA synthesis resulted from a reduction in the fraction of cells producing DNA. The concentration of arginine required for viral inhibition of DNA synthesis is greater than that for viral multiplication.