Underwater deceleration curves in relation to injuries from diving

Diving accidents result in more than 1,800 cases of paralysis from injury to the spinal cord each year. Studies have been made of underwater deceleration during diving. The mechanisms involved in spinal injury are discussed.

Control of renal hemorrhage by selective arterial embolization

An attempt was made to control renal hemorrhage by selective embolization of the renal artery in 7 patients. In 2 patients the bleeding site was single, but in 2 others, several sites of arterial extravasation were present. Two patients had arteriovenous fistulas, and 1 had an unsalvageable, macerated kidney. Six of the 7 patients (86 per cent) were treated successfully. Nephrectomy was avoided in 5. No patient developed hypertension during the follow-up of 4 months to 2 years. Our results in these patients indicate that selective arterial embolization should have an important place in the management of patients with renal trauma.

BCG vaccination of children against leprosy: nine-year findings of the controlled WHO trial in Burma

The leprosy incidence rates so far in the vaccinated and unvaccinated children aged 5-9 and 10-14 years are similar. The BCG-vaccinated children aged 0-4 years at intake had an incidence rate lower than that of children in the control group. BCG vaccination did not protect household contacts or children aged 5-14 years not exposed in the household, and did not influence the distribution of the forms of leprosy in the cases detected. The lepromin reaction in relation to the age at intake was consistently stronger in the vaccinated children than in those of the control group; the younger the age group the more pronounced was the difference, which was only slight in the age group 10-14 years at intake. If the results of the late lepromin reaction are related to the age at onset (when the children are older than at intake), the differences between the BCG and the control groups tend to decrease. It does not seem that the BCG-vaccinated children suffer from a less serious form of leprosy than the nonvaccinated children (most of them nonreactors to tuberculin).

Some epidemiological data on leprosy collected in a mass survey in Burma

In the WHO Leprosy BCG Trial in Burma a mass survey was undertaken to determine whether children had been exposed to patients with leprosy and, if so, the form of the index case. This paper presents the most important epidemiological data collected in this survey. The prevalence rate was 31.6 per 1 000. It seems that even if the prevalence rate is very high the L rate does not increase accordingly. The high T rates in areas of high endemicity seem to be related mainly to the degree of spreading of leprosy, even to persons who react to lepromin. Comparison of the results with data available for the area before the survey was made shows that 87% of the L cases had already been detected and that 54% of the T cases had not. There was a tendency for high L rates to be associated with high prevalence rates. The results do not suggest that any particular age group has greater susceptibility or resistance; the prevalence rates seemed to be related mainly to the age when exposure occurred. A higher prevalence of leprosy in males started to appear in the 10-14-year age group, and after the age of 15 the difference became impressive. Biological, socio-economic, and environmental factors seem to be responsible for the level of endemicity, which does not seem to be essentially or primarily related to ethnic origin.

Late lepromin reaction in untreated patients with indeterminate leprosy under 21 years old in Burma

Studies on lepromin reactivity in indeterminate (I) leprosy have usually been carried out among patients in whom the disease appeared 1 or more years before testing. This may result in misleading findings because a high proportion of patients, probably those showing moderate or strong lepromin reactions, seem to progress to the tuberculoid pole of leprosy in a relatively short time (<1 year), and in many the lesions heal spontaneously. The object of the present study was to determine the frequency and intensity of late lepromin reactions (macroscopic readings) in untreated I patients aged under 21 years who had had the disease for less than 1 year. Of 209 patients tested with lepromin containing 160 x 10(6) bacilli/ml only a small proportion ( not equal 7%) showed a negative or doubtful lepromin reaction, while 61.5% were 2+ and 3+ reactors. These findings indicate that a favourable outcome may be expected in most I cases in the trial area.

Proposed method for estimating leprosy prevalence based on rates in children

The authors suggest that, where leprosy prevalence data for the entire population are lacking, the prevalence in schoolchildren may be a valuable index for estimating the magnitude of the problem in areas where leprosy is endemic.