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We compared the incidence of pseudotumours after large head metal-on-metal (MoM) total hip arthroplasty (THA) with that after conventional metal-on-polyethylene (MoP) THA and assessed the predisposing factors to pseudotumour formation. From a previous randomised controlled trial which compared large head (38 mm to 60 mm) cementless MoM THA with conventional head (28 mm) cementless MoP THA, 93 patients (96 THAs: 41 MoM (21 males, 20 females, mean age of 64 years, standard deviation (sd) 4) and 55 MoP (25 males, 30 females, mean age of 65 years, sd5) were recruited after a mean follow-up of 50 months (36 to 64). The incidence of pseudotumours, measured using a standardised CT protocol was 22 (53.7%) after MoM THA and 12 (21.8%) after MoP THA. Women with a MoM THA were more likely to develop a pseudotumour than those with a MoP THA (15 vs7, odds ratio (OR) = 13.4, p < 0.001). There was a similar incidence of pseudotumours in men with MoM THAs and those with MoP THAs (7 vs5, OR = 2.1, p = 0.30). Elevated cobalt levels (≥ 5 microgram/L) were only associated with pseudotumours in women with a MoM THA. There was no difference in mean Oxford and Harris hip scores between patients with a pseudotumour and those without. Contrary to popular belief, pseudotumours occur frequently around MoP THAs. Women with a MoM THA and an elevated cobalt level are at greatest risk. In this study, pseudotumours had no effect on the functional outcome after either large head MoM or conventional MoP THA.Cite this article: Bone Joint J2015;97-B:1481–7.

A role of nitric oxide (NO) has been suggested in the airway response to exercise. However, it is unclear whether NO may act as a protective or a stimulatory factor. Therefore, we examined the role of NO in the airway response to exercise by using N-monomethyl-l-arginine (l-NMMA, an NO synthase inhibitor), l-arginine (the NO synthase substrate), or placebo as pretreatment to exercise challenge in 12 healthy nonsmoking, nonatopic subjects and 12 nonsmoking, atopic asthmatic patients in a double-blind, crossover study. Fifteen minutes after inhalation of l-NMMA (10 mg),l-arginine (375 mg), or placebo, standardized bicycle ergometry was performed for 6 min using dry air, while ventilation was kept constant. The forced expiratory volume in 1-s response was expressed as area under the time-response curve (AUC) over 30 min. In healthy subjects, there was no significant change in AUC betweenl-NMMA and placebo treatment [28.6 ± 17.0 and 1.3 ± 20.4 (SE) for placebo and l-NMMA, respectively,P= 0.2]. In the asthmatic group, l-NMMA and l-arginine induced significant changes in exhaled NO (P< 0.01) but had no significant effect on AUC compared with placebo (geometric mean ± SE: −204.3 ± 1.5, −186.9 ± 1.4, and −318.1 ± 1.2% · h for placebo,l-NMMA, and l-arginine, respectively,P> 0.2). However, there was a borderline significant difference in AUC between l-NMMA and l-arginine treatment (P= 0.052). We conclude that modulation of NO synthesis has no effect on the airway response to exercise in healthy subjects but that NO synthesis inhibition slightly attenuates exercise-induced bronchoconstriction compared with NO synthase substrate supplementation in asthma. These data suggest that the net effect of endogenous NO is not inhibitory during exercise-induced bronchoconstriction in asthma.

Using the proper geometry of methanol, a 16-parameter valence force field has been calculated for CH3OH, CD3OH, CH3OD and CD3OD.

English Literature in the Earlier Seventeenth Century 1600-1660. By Douglas Bush, vi + 621. Clarendon Press, Oxford, 1945. 21s. net.Casopis pro Moderni Filologii (A Journal of Modern Philology)A Poet and a Theatre. By Dr. A. N. Jeffares. 20 pp. J. B. Wolters' Uitgevers-Maatschappij, Groningen-Batavia. 1946.Humanitas. A University Quarterly. Vol. I, No. 1: Summer 1946. 46 pp. Published by the Editors — From the University Union, Manchester 15. Price 2s. 6d.Richard Crashaw. Di Mario Praz. 200 pp. Brescia: Morcelliana. 1946. L. 170.—Modern Travel. An Anthology. Selected and edited by Frederick T. Wood, vii + 220 pp. Macmillan. 1946. 3/6.Modern Autobiography. An Anthology. Selected and edited by Frederick T. Wood, ix + 245 pp. Macmillan. 1946. 3/6.Anglica. Rivista di Studi Inglesi e Americani. I, 1, 2-3. Febr.-Aug. 1946. G. C. Sansoni, Editore, Firenze. (Annual Subscription abroad L. 800.)

From experiments carried out on White Leghorn cockerels about 10 weeks old, Mighorst(1951 and 1953) concluded that methylthiouracil (M. T. U.) has a pronounced effect on the thyroid gland only if the protein-percentage of the food is sufficiently high. The histological thyroid gland activity, as well as the diminution in metabolism of cockerels which received a diet containing 25.3 % and 34.3 % raw protein was considerably greater than in the case of animals kept on food with 12,1 %2raw protein.In recent publications Mighorst & van der Veen(1952) and Mighorst(1953) suggest that, for a distinct action of methylthiouracil, it is essential that the food of cockerels should contain a sufficiently high percentage of protein – in this case added to the food as casein. Here it was also found that the influence of methylthiouracil on the thyroid gland is distinctly visible only when casein is added to

In an earlier publication the senior author expressed the view that the ovipositor test can be satisfactorily used for the demonstration of small quantities of progesterone in single human corpora lutea (cf. Bretschneider & Duyvené de Wit, 1947, p. 30) and follicular fluid (cf. Duyvené de Wit, 1941).This view is based on the fact that, compared with many other steroids tested, progesterone has a very high activity in the ovipositor test and shows growth curves that are characterized by a latent period of one hour followed by a period of linear growth of 3½ hours.After this, there is only slight additional growth, cf. Fig. 1. This type of growth curve, however, can only be obtained when1) Present address: University of the O. F. S. at Bloemfontein (South-Africa).2) 46th Communication of the » voor Endocrinologie«.sensitizedand selectedbitterlings are used and the

An important question for the practical application of the ovipositor test is, how many times can the same fish be used in succession. It might, indeed, seem possible that the bitterlings, after a number of successive reactions, either lose their reactivity or become hypersensitive; in the latter case this would cause their reactions to become relatively too strong.The following experiment, made some time ago by one of the authors (Duyvené de Wit, 1939, p. 28, and 1940, p. 141), throws some light on this question.A group of 12 fishes was given a series of tests at 2-day intervals. The results are given in Table 1.1) Present address: University of the O. F. S. at Bloemfontein (South-Africa).2) 47th Communication of the »Werkgemeenschapvoor Endocrinologie«.It will be seen that the first 4 tests were identical in that 3 ml. of active urine (A)

A novel approach is described by which to identify the sentinel lymph node in patients with stage I melanoma. The technique involves a combination of intradermal patent blue V injection and γ probe-assisted surgery. Eleven patients with previously resected cutaneous melanoma, clinical stage I (Breslow thickness 1.35–3.20 mm), underwent sentinel node biopsy. Before surgery lymphoscintigraphy was performed to evaluate the pathways of lymphatic drainage from the site of the previously resected melanoma. A handheld γ probe was used to localize the sentinel node and to define the exact site of incision. At the same time, patent blue V (0.1–0.2 ml) was injected intracutaneously on either side of the scar to visualize the afferent lymphatic ducts and lymph nodes. By combining the use of the γ probe and vital dye staining, the sentinel node could easily be localized and identified in all 11 patients. After removal of the sentinel node(s) no residual radioactivity could be traced. In four patients with micrometastases in the sentinel node standard lymph node dissection was performed, including excision of the biopsy site; in only one lymphadenectomy specimen were micrometastases found in two other lymph nodes.

A novel approach is described by which to identify the sentinel lymph node in patients with stage I melanoma. The technique involves a combination of intradermal patent blue V injection and γ probe‐assisted surgery. Eleven patients with previously resected cutaneous melanoma, clinical stage I (Breslow thickness 1.35–3.20 mm), underwent sentinel node biopsy. Before surgery lymphoscintigraphy was performed to evaluate the pathways of lymphatic drainage from the site of the previously resected melanoma. A handheld γ probe was used to localize the sentinel node and to define the exact site of incision. At the same time, patent blue V (0.1–0.2 ml) was injected intracutaneously on either side of the scar to visualize the afferent lymphatic ducts and lymph nodes. By combining the use of the γ probe and vital dye staining, the sentinel node could easily be localized and identified in all 11 patients. After removal of the sentinel node(s) no residual radioactivity could be traced. In four patients with micrometastases in the sentinel node standard lymph node dissection was performed, including excision of the biopsy site; in only one lymphadenectomy specimen were micrometastases found in two other lymph nodes.