THE INTERSEXED PATIENT

There are at present two opposing points of view on problems of dealing with the intersexed patient (not the typical homosexual or transvestite) who has clearcut anatomical or biochemical qualities of the opposite sex. The first is that in the growing child or adult coming for treatment, the sex the patient should adopt is the summation of somatic sex. The other is that the sex role should be assigned according to the predominant psychological identification already present.A case history of a middle-aged pseudohermaphrodite, castrated in youth but raised from birth as a female and living thus in “homosexual” relations with women until examined and interviewed at UCLA Medical Center is presented to illustrate the psychological problems in sexual identity with which the patient had to cope.Psychiatric investigation revealed how confused the patient''s sex identity was until treatment by a team consisting of psychiatrist, psychologist and endocrinologist permitted the patient, even at so late a date, finally to establish what his gender is. The patient was able, despite early rearing as a female and a castrating operation, to swing to a more masculine identification. This was possible because of some uncertainty of sexual role from an early age.     

ORBITAL AND PERIORBITAL TUMORS—Indications for Exenteration

The anatomical location of the orbit, its relationship to surrounding structures and the vital concern to preserve sight, create special problems in the treatment of orbital and periorbital tumors.Specific diagnosis of orbital tumors can be made only by biopsy. Frozen section technique is very helpful when available. Roentgenographic visualization of the orbital bones is a valuable adjunctive method of determining the extent and type of tumor.The three most common forms of lacrymal gland tumors are benign “mixed tumors,” adenoid cystic carcinomas (cylindromas), and adenocarcinomas.A method of therapy for the treatment of orbital and periorbital tumors is described and the indications for exenteration are discussed.     

Clostridium perfringens in Meat and Meat Products

A total of 262 specimens of meat and meat dishes were examined for the presence of Clostridium perfringens. Of this total, 161 were raw, unprocessed beef, veal, lamb, pork, or chicken; 101 were processed meats and meat dishes. C. perfringens was isolated from 113 (43.1%) of these specimens. The highest percentage of contamination (82%) was found in veal cuts, and the lowest (4.7%) in sliced sandwich meats and spreads. Only 2 of the 113 isolates were shown to produce heat-resistant spores, which indicates a very low incidence (0.8%) of contamination. These findings indicate that outbreaks of C. perfringens food-borne disease in the Cincinnati area are caused principally by the contamination of the food with vegetative cells or spores of the organism after cooking. Studies of the effects of various holding temperatures on the growth of C. perfringens indicated that, in the range of 5 to 15 C, no multiplication would occur, but that viable cells would still be present at the end of a 5-day holding period. Extremely rapid growth occurred at temperatures around 45 C, and complete inhibition of growth was accomplished between 49 and 52 C.