Cholelithiasis and Cholecystitis in Childhood

Six cases of cholecystitis and cholelithiasis confirmed by x-ray examination and surgical operation were observed in a ten-year period. Due to the wide variability in signs and symptoms in children, cholecystitis and cholelithiasis can be diagnosed only with a high degree of clinical suspicion and roentgenological examination. Gallbladder disease is uncommon in childhood but should be considered in children with vague abdominal pains or bouts of unexplained jaundice. If a normal appendix is found at laparotomy in the “acute abdomen,” the surgeon would be wise to palpate other specific organs within the abdomen, including the liver and gallbladder.The treatment of choice is cholecystectomy. The prognosis for recovery is excellent if there is no complicating systemic disease.     

Direct Cord Reading Medium for Isolation of Mycobacteria

A study of growth and colony morphology of mycobacteria was performed on 7H10 medium and compared with the same medium to which WR 1339 was added. Collection strains of human, bovine, and atypical mycobacteria, in addition to 1,199 sputa, were planted on both media. The results showed that WR 1339 modifies the growth and colony morphology of human, bovine, atypical group I, and, to a lesser degree, atypical groups II, III, and IV mycobacteria. The great majority of human and bovine strains exhibit definite cords when examined at a magnification of 100 times. The colonies are larger when WR 1339 is added, especially if there is a small number of colonies. The addition of WR 1339 spreads the growth on the surface of the agar, producing a thin but larger colony as compared with 7H10 medium alone on which the colonies grow more vertically, thus producing thick but smaller colonies. WR 1339 spreads the growth, producing thin and transparent colonies where the cords are oriented in uniplane and easily visible directly on the isolation media. Half of the positive sputum cultures were easily identified at 12 days. The presence of typical cords permits a quick screening diagnosis of species directly on the isolation media and, in most instances, elimination of the possibility of atypical or contaminating colonies.     

Kurze Mitteilungen

Zusammenfassung Ein Paar Türkentauben brütete vom 29. 1. bis 15. 2. 1966 auf einem Straßenbaum in Berlin-Tempelhof. Es wurde nur ein Ei gelegt. Nach 17 Tagen schlüpfte das gelbbedaunte Junge. Es ist dann kurz danach, wahrscheinlich beim Umherkriechen auf dem Nestrand, erfroren. Die Umstände, unter denen die Brut erfolgte, waren äußerst ungünstig. Die Temperatur lag seit dem 7. 2. 1966 dauernd unter Null (–9 und –13 Grad). Die brütende Taube hatte von Anfang an auf dem Nestrand brüten müssen, da die Mulde schon vor der Eiablage völlig mit Schnee bedeckt war. Der brütende Vogel war mehrere Tage und Nächte von einem hohen Schneewall umgeben, der sich auf dem Nest gebildet hatte. Dieses Nest wurde von Mai 1964 an viermal von einem Türkentaubenpaar zum Brüten benutzt. Es wird vermutet, daß zum mindesten der eine Partner, der Tauber, während der ganzen Zeit derselbe geblieben ist.     

Oxalyl thiolester concentrations decreased in lectin and phorbol ester-stimulated lymphocytes

Oxalyl thiolesters (OTEs) are a newly discovered class of mammalian metabolites that are believed to function in controlling animal metabolism and possibly serve as intracellular mediators for some hormones. Previous correlations had suggested that the concentrations of OTEs might be decreased when cells are stimulated to proliferate, and in our research that was found to be the case. Thus, when bovine lymph node lymphocytes are stimulated either with concanavalin A (Con A) or with a combination of phytohemagglutinin (PHA) and the phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA), the concentration of OTEs in the lymphocytes decreases within 3 h by a factor of approximately two. With either PHA or TPA alone, the decrease in OTE concentration is considerably smaller. With Con A as stimulant, the OTE levels decrease within 1 h and remain low for at least 24 h. It was also noted that the concentration of OTEs in unstimulated isolated lymphocytes is significantly lower in lymphocytes obtained from 2-year-old animals than in lymphocytes obtained from older animals. The results of the current investigation, when considered in conjunction with other recent results, suggest that OTEs may be natural cell proliferation inhibitors.     

Use of hospital services by homeless families in an inner London health district.

Over the past decade the number of families in London who were considered officially to be homeless appreciably increased. In response to this many families have been given temporary accommodation, usually in bed and breakfast hotels, while awaiting permanent rehousing. About 200 of the roughly 600 hotels in London that provide such accommodation are located in the area of the former Paddington and North Kensington Health Authority, now part of Parkside Health Authority. The use made by the homeless population of hospital services was studied by finding out the numbers of inpatients admitted to hospital and the numbers presenting to the walk in paediatric clinic and the casualty department at one hospital. These figures were compared with those for local residents and the overall workload. The bed and breakfast population were high users of inpatient beds, the casualty department, and the paediatric clinic. Overall, about one tenth of the beds were used by these people. The health authority receives no additional funding for this group of patients. Further research is needed to find out if the high use of hospital services made by these patients reflects their increased morbidity or their inability to obtain primary care services.     

Evaluation of the cervical cytology screening programme in an inner city health district.

District health authorities have been instructed to operate a cervical cytology call and recall screening programme using the age-sex registers held by family practitioner committees. A detailed evaluation of implementation in an inner London district showed that 477 out of 687 (69%) invitation letters sent to women by the family practitioner committee were either inaccurate or inappropriate: almost half of the recorded addresses were incorrect and a further fifth of the women were not eligible for a test. Overall, 90 women had a smear, which is only 13% of the total but 43% of those found to be eligible. The findings did not differ significantly with age. The findings have major implications not only for the effectiveness of call and recall for screening for cervical cancer but also for the future development of screening for breast cancer in such areas.