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QUIS CUSTODIET ipsos custodes? Who will guard the guards themselves? queried Juvenal, the Roman poet and satirist, many centuries ago.Juvenal's remark was aimed at the dilemma of ensuring the chastity of women. But his query seems fitting for an embryonic field of study that has gained momentum during the last dozen years or so: an effort to investigate how those who oversee peer review, the evaluative action at the heart of the biomedical literature, can themselves assure that the process itself is sound.To this end, more than 300 participants from 46 countries recently gathered at the International Congress on Biomedical Peer Review and Global Communications in Prague, Czech Republic, organized by JAMA, BMJ (British Medical Journal), and Project Hope. They came to the meeting, the third such congress since 1989, to hear the latest research aimed at answering such questions as whether the process allots credit where (and

DESPITE ever more sophisticated strategies for treating human immunodeficiency virus (HIV) disease, researchers are finding that many patients suffer needlessly because physicians fail to recognize and alleviate AIDS-related pain. Studies show that although people with HIV infection and AIDS suffer pain comparable to that experienced by cancer patients, their pain is "dramatically undertreated, even in academic centers with a focus on HIV care," said William Breitbart, MD, at a recent international congress on pain held in Vancouver, British Columbia. "The story of pain in AIDS has been a story of neglect," noted Breitbart, of Memorial Sloan-Kettering Cancer Center, New York, NY. And the problem may be exacerbated by pressures of managed care that result in greater numbers of people with HIV and AIDS being cared for by primary care physicians, many of whom have little training or experience in managing chronic pain. "Most physicians haven't been trained in

spent my entire clinical career taking care of patients with head and neck disease. And my professional identity is deeply tied to the origins of the American Head and Neck Society. I have at various times served on the council of the American Society for Head and Neck Surgery and have served as its treasurer and president. Perhaps most meaningful, I had the opportunity to co-chair, with Eliot Strong, who then headed up the Society of Head and Neck Surgeons, the First International Congress on Head and Neck Cancer. It was a terrific opportunity to work with members of the Society of Head and Neck Surgeons, like Eliot Strong. The Congress went very well and Eliot and I were asked to chair the Second International Congress. And I was president of the American Society for Head and Neck Surgery during the third Congress. Those meetings went well, too, and we were laying important foundation stones for the future.

1. Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289:179-186. 2. Serfling RE. Methods for current statistical analysis of excess pneumoniainfluenza deaths. Public Health Rep. 1963;78:494-506. 3. Simonsen L, Clarke MJ, Williamson CD, et al. The impact of influenza epidemics on mortality: introducing a severity index. Am J Public Health. 1997;87:1944-1950. 4. Simonsen L, Reichert T, Miller M. Effect of influenza vaccination in the United States: prevention of mortality among the elderly. Abstract presented at: First European Influenza Conference; October 20-23, 2002; St Julians, Malta. 5. Simonsen L, Schonberger LB, Stroup DF, et al. The impact of influenza on mortality in the USA. In: Brown LE, Hampson AW, Webster RB, eds. Options for the Control of Influenza III. New York, NY: Elsevier; 1996:26-33. International Congress Series 1123.

We have now held four peer review congresses at four year intervals, and their success is shown by the stimulus they have given to an evolving science—investigation of the process whereby scientific work is selected and published.1–4 Since the announcement of the first peer review congress in 1986, the numbers of abstracts submitted to successive congresses have increased from 50 to 110, 160, and 180, respectively. We have noted similar increases in the number of Medline citations on peer review, which since 2000 have averaged 170-200 per year.5 We now …

SANTA FE, NM—Can early treatment, preferably begun even before psychotic symptoms emerge, improve long-term outcomes for people with schizophrenia? That hope, according to researchers presenting new findings last month at the International Congress on Schizophrenia, is sparking efforts to identify early signs of the disease in high-risk individuals and to develop interventions aimed at delaying its onset or reducing its severity.

I read the article by Thornton 1 on middle turbinate stabilization technique in endoscopic sinus surgery in the August 1996 issue of theArchives. In 1991, at the American Academy of Otolaryngology—Head and Neck Surgery annual meeting in Kansas City, Kan, I presented this technique as a poster presentation. In the same year I also presented this technique at the International Congress of Rhinology in Tokyo, Japan. I am happy to find that Thornton has an equally favorable result from this technique. The difference in our techniques is that he uses a straight needle, whereas I use a curved needle. I find the curved needle easier to insert compared with the straight needle. In addition, I also use black nylon suture as opposed to an absorbable suture material. I found that the monofilament nylon has less tendency to accumulate crust.

Pediatric Dermatology: The World's Reality in Children's Skin chronicles the proceedings of the Seventh International Congress of Pediatric Dermatology that was held in Buenos Aires, Argentina, in September 1994. Participants came from 38 different countries to meet and contribute to a scientific program that covered a broad spectrum of dermatologic disease in the pediatric population. The text is divided into 20 sections covering a wide range of topics, such as bullous diseases, infectious and tropical diseases, nutritional disorders, acquired immunodeficiency syndrome and other immunodeficiencies, hair and nail disorders, neurocutaneous syndromes, vasculitis, and a smattering of genodermaloses and dermatopathology topics. Experts in the field have contributed editorials, reviews, and results of basic science, epidemiologic, and clinical research. The black-and-white photographs are not of the highest quality; however, there are many excellent tables and figures to summarize the information. Almost all the lectures, even those presented in only abstract form, have a

It is axiomatic that the diversity and ingenuity of strategies in the study of schizophrenia bear testimony to the complexity of this disorder. Accordingly, the opportunity for investigators of diverse interests to share their latest findings and be informed of developments in key areas of science is critical to advance our understanding of schizophrenia. Nearly 700 investigators from around the world gathered at Warm Springs, Va, to present their data at the Fifth International Congress on Schizophrenia Research (April 8-12, 1995). This 5-day conference, held every other year alternating with the European Winter Workshop on Schizophrenia, is co-organized by S. Charles Schulz, MD, Case Western Reserve University, Cleveland, Ohio, and Carol Tamminga, MD, Maryland Psychiatric Research Center, University of Maryland at Baltimore. Drs Schulz and Tamminga first held the Congress in 1987 in Clearwater, Fla, with 170 investigators presenting. The Congress has flourished since then and is now the largest research meeting devoted solely to schizophrenia. The Congress organizers, the program coordinator (Jeffrey Lieberman, MD, Hillside Hospital, Glen Oaks, NY), and the Congress coordinator (Susan Nusbaum, Maryland Psychiatric Research Center) are congratulated on the success of this event and its contribution to fostering initiatives and collaborations within schizophrenia research.

When science operates well, the publication of research occurs after expert criticism and revision and is itself followed by unrestrained criticism from the scientists' peers: the readers. The existence of a rigorous peer review system is the best sign that science is functioning in an appropriate and nurturing environment. Recognizing the central position of editorial peer review in the scientific process, we atJAMAannounced in 1986 that we intended to host a conference in 3 years at which the results of research into editorial peer review would be presented and discussed.1We received an enthusiastic response, and in 1989 the First Congress on Peer Review in Biomedical Publication was held in Chicago, under the auspices of the American Medical Association. Manuscripts developed from the research presentations were published in 1990.2In 1993 we held another conference in Chicago, receiving twice as many abstracts from which to choose

In reply We were delighted that Dr Beale provided the results of his work pertaining to ONSD found in Acta XXIII of the International Congress of Ophthalmology ' in 1978. We regret not having learned about this work in our original publication 2 because this Japanese publication was inaccessible to our database review of the literature. We do not believe, however, Dr Beale's assertion that we have an erroneous reference (reference 47) in the original article. Our reference 47 was derived from an abstract published in the American Academy of Ophthalmology's Annual Meeting's Official Program and Section on Instruction (Ophthalmology. 1979;86: 44). More importantly, we are pleased to see limited follow-up of the 14 patients on whom the author has performed ONSD. We are also grateful to Dr Beale for pointing out that opening of the sheath for cerebrospinal fluid drainage (ONSD) may not have the same functional outcome as surgery

The textbook Minimally Invasive Surgery and New Technology represents the published transactions of an international congress held in Luxembourg in September 1992. The meeting was organized by Felicien M. Steichen, MD, and Roger Welter, MD, who were also responsible for editing this book. The result is a very ambitious effort by the editors to reproduce the presentations of the entire congress within a single text. Over 300 authors are included, the vast majority representing European medical centers. Although without a doubt the main focus of the program was laparoscopic surgery, the editors have put together a collection of manuscripts that really are best described by the concepts of minimally invasive therapy and advanced diagnostic modalities. The text is divided into 21 sections with 140 separate chapters. Several authors have described their experiences with diagnostic laparoscopy and biliary tract surgery, including various methods of treating the patients with complex choledocholithiasis. Considerable

To the Editor. —The recent publication in JAMA of papers from the Second International Congress on Peer Review in Biomedical Publication 1 demonstrates quite clearly that the strategy of using periodic conferences to generate research on peer review has been successful. It is interesting to note that since the First International Congress on Peer Review in Biomedical Publication in 1989 not only has there been an increase in the quantity of research on peer review generated (from 50 to 110 abstracts submitted), 1,2 but the complexity of research appearing inThe JOURNALis greater. More manuscripts from the second congress used quantitative methods and less were of a descriptive nature. These observations relate to the future study of biomedical peer review. Is there any loss associated with the gain of a shift to quantification in peer review research? Research on diseases where behavioral factors elevate risk has sought to complement

medical scientistsas authors and speakers are being forced into a dilemma: the oral presentation of new information at a scientific meeting may jeopardize consideration of that information for publication in a peer-reviewed journal. This problem came home after I had presented a paper at the 10th International Congress of Eye Research held in Stresa, Italy, on September 21, 1993. Having been invited to present an original scientific work previously by one of the session chairmen, I had not given either oral or written consent to the video or audio recording of the presentation. Copyright ownership was not assigned to either the journal,Experimental Eye Research, which had previously published the meeting abstracts, or the organizers of the congress, the International Society for Eye Research.1To my surprise, within 1 month, I received a galley proof by way of facsimile transmission from one of the ophthalmologic tabloids that contained

In this issue ofThe Journal, we publish 26 of the papers presented at the Second International Congress on Peer Review in Biomedical Publication, held in Chicago, Ill, September 9-11, 1993. Of these 26 papers, two, those by Kassirer and Campion1and Judson,2were invited. The others were submitted in response to a concerted effort we have made during the past 8 years to stimulate research into editorial peer review.3,4 Given the subject, it is appropriate to comment on the review process used to help select these papers. We received 110 abstracts describing work to be presented at the congress. These were sent to seven independent reviewers (from the United States, Canada, and the United Kingdom) who allotted scores to each abstract; selection was made according to these scores. Thirty-three abstracts (30%) were selected for oral presentation, and 21 abstracts (19%) were presented as posters. Subsequently, the

RESEARCH is revealing much room for improvement in the long-concealed world of medical journal peer review. A host of shortcomings, from bias and error to poor readability and a lack of clear standards, were documented in studies presented at the Second International Congress on Peer Review in Biomedical Publication, held in Chicago, Ill. See also p 2856. The meeting, sponsored by the American Medical Association, was designed "to stimulate research, not rehash editorial opinion," says congress director Drummond Rennie, MD, Deputy Editor (West), JAMA , Chicago, Ill. "We are looking closely for information we can put into practice" to improve "and, if necessary, reinvent" medical journals, says George D. Lundberg, MD, Editor, JAMA . Need for Standards Despite Rennie's call to focus on research, calls for establishing standards peppered the meeting. Speakers cited a need for clear statements of the types of reasons papers are rejected, what is expected from reviewers, how

These books are multiauthored compilations of the presentations from meetings of international experts. They do not attempt to provide the comprehensive and even coverage that would be found in a textbook; instead, both books review some topics of current interest in basic and clinical glaucoma research. Although these texts provide fascinating surveys of certain topics in glaucoma research, as with any book of this type, the information they contain could become rapidly outdated with continued progress in the field. "Clinicians will find only a little information of direct relevance to patient care..." Glaucoma Update IV contains 40 presentations from the fourth meeting of the Organizing Committee of the Glaucoma Society of the International Congress of Ophthalmology, which was held in March 1990 in Bali, Indonesia. This meeting is attended by committee members and invited experts and precedes the International Congress of Ophthalmology, held under the auspices of the International Council

Fifty-eight percent of the world's blind live in Asia. More than half of these cases are due to treatable cataracts and most of the rest are due to preventable diseases, yet less than 2% of the population have access to modern eye care. With these figures in mind, it was appropriate that the theme of the well-organized and well-attended 26th International Congress of Ophthalmology was "Prevention of Blindness." The publication of these three volumes coincided with that event. "... the general reader who is unfamiliar with Asian and third-world ophthalmology will find many selections interesting and enlightening." These slim books are glossy and colorful. The World's Major Blinding Conditions (volume 3) will most interest the general reader. No bibliographic citations are given, and no scientific reports are included. This work is a history and celebration of the myriad institutions, especially the "International Association for the Prevention of Blindness," involved in philanthropic

IN RECENT years, scientists and editors of scientific journals have often noted how few hard data exist on the workings of editorial peer review. Although pressures from inside and out increasingly encourage journals to be more explicit about their practices and more inclined to question their own habits, there is still a good deal of truth in the sardonic observation made 5 years ago that "the arbiters of rigor, quality, and innovativeness in publishing scientific work do not apply to their own work the standards they apply in judging the work of others." 1 This paradox inspired The First International Congress on Peer Review in Biomedical Publication, with its goal of encouraging the systematic and empirical study of journals. Of course, data and rigorous methods are not enough to make a science. The systematic study of peer review is even more deficient in theory than it is in data. Some

In May 1989, the American Medical Association sponsored The First International Congress on Peer Review in Biomedical Publication. This issue ofJAMAis dedicated to papers first presented at that congress, themselves greatly modified by editorial peer review. We atJAMA, considering that publication lies at the heart of the scientific process and that at the heart of publication lies peer review,1were impressed by the evident lack of research2into a process that occupies our energies daily and on which we, as editors, are disposed to rely heavily. We recognized that the vast majority of papers written about editorial peer review had been composed in the absence of any data and were editorial effusions that expressed individual biases. Scientific investigations in this field were woefully lacking, and we set out to change this state of affairs.3 Our objectives in holding the congress were simple: to stimulate

Gunter Kreiglstein edited a collection of reports presented at the third committee meeting of the Glaucoma Society of the International Congress of Ophthalmology held in Bussum, the Netherlands, from September 11 to 14, 1986. Over 80 distinguished researchers in the field of glaucoma produced 37 reports covering a wide variety of subjects that were discussed at this normally "closed" meeting. The contents of this volume have been loosely grouped into broad, related topics. Both basic sciences and clinical research are well represented. Broad areas of investigation include trabecular meshwork morphology, optic nerve morphology and physiology, epidemiological investigations of infantile and primary open angle glaucoma, automated visual field studies, both experimental and clinical laser studies, antimetabolites in filtering surgery, and new approaches in pharmacological management of glaucoma. In general, these reports are well written and concise. Illustrations, tables, and micrographs are sufficiently employed throughout. Bibliographies are a valuable addition to each

IN theJournal of Cutaneous and Genito-Urinary Diseasesfor June, 1889, I published the account of a remarkable case of cutaneous disease, such as I had never seen before, and of which I could find no description in literature. It was characterized by concretions of epithelial cells, varying in size from the head of a pin to horn-like masses of half an inch in height, which had their origin within the mouth of the sebaceous glands, and occupied nearly the whole surface of the body. I called the disease, therefore, keratosis follicularis. At the International Congress of Dermatology, held at Paris in August, a patient was shown as an example of an affection described by Darier, chef du laboratoire de la Faculte a l'hopital Saint-Louis , in the "Annales de dermatologie et de syphiligraphie," July 25, 1889, under the title psorospermose-folliculaire vegetante . The same affection had formed the subject of a "These de Paris" by Dr. A. Thibault, May 8, 1889. M. Darier had previously made a communication upon the subject before the Societe de biologie on March 25, 1889. The observations of these gentlemen, unknown to me before the meeting of the congress, were based upon two cases of the affection which had been seen at the Saint Louis Hospital during the preceding year. One of these was the patient exhibited to the congress, and the appearances he presented were identical with those of my patient, although the lesions in the former were far less developed in diversity and magnitude, as the duration of the disease was only eight years. I had no hesitation in pronouncing the affection to be the same as that described by myself under the name keratosis follicularis, and stated further that, although I was not prepared to deny the correctness of M. Darier's conclusions as to the parasitic nature of the peculiar cells found in the epidermal concretions, neither Dr. Bowen, who had made the microscopic studies in my case, nor myself had recognized them as of such a character. J Cutan Genito-Urin Dis. January 1890;8:13-20.

The First Annual International Congress for Interferon Research, held in Washington, DC, during the fall of 1980, left the impression that interferon as an anticancer drug was intriguing but unproved (JAMA [MEDICAL NEWS] 1981;245:109-116).The second congress, held recently in San Francisco and, like the first congress, well attended by scientists, the business community, and the press, left much the same impression. However, some new questions, for example, those concerning interferon's possible role in disease induction, came to light.At the time of the first congress, the results of the American Cancer Society-sponsored phase I trials of interferon in cancer patients were known. They were highly variable—reported tumor regression ranged from 0% to 40%—and raised several questions, such as these: Was the variability of response due to the kind of interferon used for treatment (there are three major groups of interferons that include a minimum of 20 distinct entities)? Was

REPORTS of the current status of marijuana research were presented at a symposium on marijuana held in July 1978 in Reims, France, under the aegis of the Seventh International Congress of Pharmacology.1-2More than 100 scientists from 14 countries attended the meeting sponsored by the National Institute on Drug Abuse (NIDA), The French Ministry of Health, the French National Institute for Health and Research (INSERM), and the International Medical Council on Drug Use. Organizers of the symposium were Gabriel G. Nahas (Columbia University), W. D. M. Paton (Department of Pharmacology, Oxford University), and Monique Braude (NIDA). Analysis, metabolism, cellular responses, and effects on reproduction and on the brain were the topics discussed during the two-day meeting. Pharmacokinetics The pharmacokinetics (absorption, distribution, biotransformation, and elimination) of the psychoactive substance of marijuana—Δ9-tetrahydrocannabinol, or THC—and of its byproducts (metabolites) were described by E. R. Garrett (University of Florida). Unlike water-soluble

A new class of antiulcer drugs—it is hoped—may be as effective as the histamine receptor antagonists (H2 blockers) in inhibiting gastric acid secretion.However, the activity of this new class may go beyond that, according to a series of clinical trials presented at two medical conferences in Portugal— the XII International Congress of Gastroenterology in Lisbon, and a symposium on prostaglandins in the Algarve.The new drugs are laboratory devised derivatives of naturally occurring prostaglandins. Preliminary indications are that, in addition to inhibiting gastric acid secretions and helping to heal ulcers, they may protect the gastroduodenal mucosa against potential damage from aspirin, alcohol, and other agents. As such, they might be particularly useful in patients with rheumatoid arthritis and for other persons who routinely ingest large amounts of nonsteroidal anti-inflammatory agents, some of the conference reports suggest. However, larger clinical trials remain to be done, and questions about factors

Pathologic Anatomy and Pathogenesis of Otosclerosis. Dr. Otto Mayer, Vienna, Austria. The osseous neoplasm in otosclerosis is resorptive, consists primarily of endochondral bone and develops in the cavities and arches of the otic capsule in the form of foci or cords which surround this area in ringlike formation. It is classified under tumorous hyperplasia because of the construction and inclination to hyperplasia. A small accumulation of endochondral tissue at the point of origin of the neoplasm presents as a type of tissue malformation, from which the neoplasm develops, the hamartoma of E. Albrecht and the hamartoplasia of M. Weber. The neoplasm originates in the margins of the fenestra and the arches of the osseous capsule of the labyrinth. From the standpoint of structure this development is strongly mechanical. Fissures are found in the same places as a result of mechanical taxation of the bone. Thus the osseous neoplasm in otosclerosis

INTRODUCTION In 1922, I read before the International Congress of Ophthalmology, held at Washington, a paper entitled "Bitemporal Contraction of the Visual Field in Pregnancy," with a report of the findings in the visual field in thirty-one cases of normal pregnancy with no ocular lesions, in twenty-two (70.97 per cent) of which there were changes in the limits of the visual field of the nature of bitemporal contraction, which I associated with the normal enlargement of the hypophysis in pregnancy, with a corresponding compression of the chiasm. In this paper I referred to the fact that similar defects had been reported by Bellinzona and Tridontani 1 in 1903, and by Forti 2 in 1910, A subsequent review of the literature by others and myself showed that Igersheimer, 3 in 1916, in an article on the detection of morbid processes in the visual pathways, referred to deformation of the visual

IN SEPTEMBER of this year the International Congress of Ophthalmology will hold its 17th meeting in Montreal and New York. It was 97 years ago—Sept. 13-16, 1857—that this body met for the first time in Brussels, Belgium. This city was then the home of the first exclusively ophthalmological journal ever published, Annales d'oculistique . It seems somehow fitting that the editors of the first journal of ophthalmology should have been the originators and organizers of the first International Ophthalmological Congress and that Brussels should have been the meeting place. It is generally agreed that this meeting was the first international medical congress of any sort. The January, 1857, issue of the Annales carried the first public announcement of the proposed Congress. To supplement the appeal, the journal's editors, in conjunction with the Belgian diplomatic corps, circularized doctors throughout the western world. In the United States the Belgian charge d'affaires extended the

Twenty years ago, the twelfth International Congress of Ophthalmology was held in Lucerne. The thirteenth, originally planned for St. Petersburg in the summer of 1914, was prevented by the World War. Ten years elapsed following the armistice before it was possible to gather the ophthalmologists of the world together. The stage was set in Amsterdam, the time September 5 to 13, and except for an occasional shower the sun shone brightly each day. A vast amount of preliminary spade work had been done by the Dutch colleagues Zeeman, Marx, van der Hoeve, Rochat, Weve, Mulock-Houwer, Roelofs and many others. There was a central registration hall at the Kolonial-Institut, in which building the exhibits were installed and many of the meetings held. Here each member had his own private box in which all notices and correspondence were placed each day, here was a banking office, the executive offices of

An attempt was made by the International Congress of Ophthalmology in 1929 to gather information concerning the method of presenting the subject of ophthalmology to undergraduate and postgraduate students in all the countries of the world, and I was assigned the task of collecting the data from England and her dominions and from North and South America. With your permission I shall draw on some of the material collected for that report. In this country, letters were sent to the colleges and universities in "Class A" group as graded by the American Medical Association, requesting information on the number of hours devoted to the teaching of ophthalmology, together with the method of presenting the subject before the undergraduate students. Replies were received from forty colleges and universities. From these data the following facts were assembled: In six institutions ophthalmology is not taught as a special subject. In the

For many years ophthalmologists have realized that progress toward the solution of the problem of glaucoma has been so dishearteningly slow that something more definite must be achieved in regard to this question. The symposium on glaucoma at the Thirteenth International Congress of Ophthalmology, held in Amsterdam, the Netherlands, in 1929, did nothing to improve the situation. Duke-Elder, Magitot, Wessely and von Haagen, who reviewed the subject, confessed that the mystery was as profound as ever. Having studied the problem for many years, our colleagues and we felt that the prevailing theories were leading nowhere. Gradually one of us developed a theory of his own as to the nature of glaucoma, differing in many respects from prevailing theories. We felt, also, that no progress would be made except by means of a carefully thought out plan of action not only involving theoretical considerations and laboratory investigations but combining

UNDER the influence of the great masters of otology, Wittmaack, Holmgreen, and Sourdille et al, 1 whose opinion we learned to appreciate in personal contact, much of our time has been dedicated to the study of otosclerosis. As early as 1939, 2 one of us (A.S.) published his first experiences with surgical treatment of this disease, which started in 1936 immediately after the International Congress of Otorhinolaryngology in Berlin where otosclerosis was the center of interest. The present publication is a survey of our results published hitherto in German and in French. We were primarily interested in the genesis of the disease but started our investigations with the classification of the pathological processes and statistical data concerning frequency. According to the fundamental studies of Wittmaack, Mayer, 3 and especially of Nager and Meyer 4,5 and Weber, 6 otosclerosis must be considered as a fibrous osteodystrophy localized in the labyrinthine capsule.

In 1887, Majocchi for the first time observed, and in 1896 for the first time published, a report of a hitherto undescribed dermatosis, "purpura annularis teleangiectodes," and enlarged on it, in 1898, in the Archiv fur Dermatologie und Syphilis , as a contribution to the Festschrift for Pick. In a memoir to the Royal Academy of Sciences of Bologna, in 1904, he collected reports of his cases, seven in all, and published them in book form in honor of Pick's anniversary. In 1912, at the International Congress of Dermatology and Syphilis at Rome, he reported a further series of six cases, 1 so that the first observer of this unrecorded skin malady had a collection of thirteen cases to report within a period of twenty-five years. This rather small number evidences the comparative rarity of the disease. It was fully eight years before another observer, Brandweiner, published an exhaustive paper based

Barely 13 years after its initial discovery, the hypothalamic luteinizing-hormone releasing hormone (LHRH) appears to be claiming a large territory in clinical medicine. "There's almost no subspecialty of medicine that will be left untouched by the [research] advances associated with LHRH or its analogues," predicts William F. Crowley, MD, associate professor of medicine at Harvard University Medical School, Boston. He points out that this polypeptide hormone (also known as gonadotropin-releasing hormone or GnRH) is already providing new treatments for several human diseases and "represents one of the examples where an investment in basic science has profound clinical applications." Crowley, who is also chief of reproductive endocrinology at the Massachusetts General Hospital in Boston, discussed the therapeutic implications of LHRH and its analogues at the Seventh International Congress of Endocrinology in Quebec City. So far, he says, the ability of LHRH to either stimulate or suppress reproductive processes has been applied

A variety of appliances have been used or devised for ophthalmostatometry, that is, the measurement of the position of the eyeball within the orbit. According to Morax, 1 the earliest special model was the exophthalmometer of Cohn, 2 shown in 1868 at the Paris meeting of the International Congress of Ophthalmology. Volkman 3 in 1869 and Emmert Keyser 4 and Zehender 5 in 1870 individually proposed modifications of Cohn's instrument. To Zehender belongs the credit for the first use of mirrors in recording the degree of exophthalmos. Snellen 6 presented a further modification, in the textbook of de Wecker and Landolt. A more elaborate instrument was described by Ambriolet 7 in 1893, and perhaps the most complete (as well as the most cumbersome) of all the models was the statometer which Birch-Hirschfeld 8 demonstrated in 1900. Much earlier, Donders had used the ophthalmometer of Helmholtz to

To the Editor:— I am writing to acquaint our American colleagues with the Second International Congress on Medical Neutrality in Time of War, to be held Nov 12-14, 1964, at the Pasteur Institute, Paris. The aim is to evolve a practical means for all medical units (of neutral as well as belligerent countries) to be protected so their humanitarian work can be carried out effectively, regardless of which belligerent is in possession of a territory. Whatever the number of casualties in a new world war, it is certain that military and civilian health services on both sides will be overburdened. If health agencies wish to provide care of proper magnitude they will have to seek the help of additional physicians. Use of medical personnel from non-belligerent countries is not only accepted, but recommended, by the Geneva International Conventions. Switzerland admitted both French and German prisoners with tuberculosis in the First

This decade is witnessing a revived interest in the clinical application of the breathing of oxygen and various gas mixtures at increased pressure, an interest rekindled by developments in fields which appear, at least superficially, to be unrelated. SCUBA diving (self-contained underwater breathing apparatus); use of caissons with compressed air, for working under water; pressurized cabins for high-altitude airplanes; the problems of rapid decompression encountered in escaping from submarines, all bear on this modality of treatment. The spark setting off the current boom came from Amsterdam, where, in 1956. the surgeon Boerema used a technique of drenching patients, in a pressurized tank, with oxygen at three atmospheres of pressure, prior to interrupting the circulation for cardiac and vascular surgery. He and Brummelkamp applied the same technique to cases of gas gangrene in 1960 with startling success. The present book represents a compilation of the talks given at the First International

This compact book comprises the proceedings of the second International Symposium on Visual Optics, held in Tucson, Arizona, on Oct 23 to 25, 1982, as a satellite meeting of the 24th International Congress of Ophthalmology. Contributors included visual scientists, ophthalmologists, optometrists, and optical engineers from both academia and industry. Countries represented included the United States, Japan, Canada, France, England, and Switzerland. Two keynote addresses are included in the publication, a provocative essay on the anatomy of ocular optics by R. A. Weale, and an up-to-date review of electrophysiologic testing by I. M. Siegel. A section on optical characteristics of the eye includes mathematical modeling and a method to locate the visual axis precisely. The section on objective refractometry includes some of the first published descriptions of the Japanese infrared automated refractors, along with clinical trial data and accommodation studies. A section on applied optics includes articles on the theory and

That type of meeting called symposium, in which a selected few gather to discuss some topic of mutual interest, seems to be the mode of our times. The occasion of the recent International Congress of Ophthalmology in Brussels stimulated the holding of several such symposia having no official connection with the Congress itself and being held in various parts of Europe either before or after the Congress. One of these symposia, "The Transparency of the Cornea," was organized by Sir Stewart Duke-Elder under the auspices of the Council for International Organizations of Medical Sciences. It was the second symposium to be held under such auspices and, like the first ("Glaucoma," 1954), the presentations are to be published in book form. This symposium was held over a five-day period in one of Belgium's deluxe hotels at the coastal resort of Kokke-Le Zoute. The chairman maintained an atmosphere of informality and good-natured

This volume contains the program abstracts of presentations given at the Third International Congress of Neurological Surgery held in Copenhagen in August 1965. The articles, mostly in English with a few in French and German, cover a wide variety of subject matter. Those of the invited speakers are illustrated and have bibliographic citations in addition to a brief review of their presentations.

This book give an admirably edited account of the profound progress made in the last five years in the application to studies of the tissues of the eye of new methods such as electron microscopy, histo- and cytochemistry, autoradiography, and specialized techniques of immunology, biochemistry, and biophysics. It seems to me that this publication fills a definite need because of the diversity of the subject matter on one hand, and on the other, the inquisitiveness and high competence of the contributors. At first glance, the 566 pages document a kind of scientific explosion as new concepts emerge from the voluminous body of new information derived from modern investigative approaches. It illustrates the implicit impact of the symposium which has been arranged by Dr. George Smelser at the occasion of the Seventh International Congress of Anatomists in New York. In the program, the main emphasis has been placed on studies of

The 6th International Congress of Electroencephalography and Clinical Neurology met in Vienna in 1965. Three Round Table Symposia were held: (1) Functions of the Spinal Cord: Experimental and Clinical Aspects; (2) Modern Trends in the Neurophysiological Investigation of Brain Diseases; and (3) The EEG in Stress: Physiological and Psychological Aspects. The spinal cord is treated from two points of view, animal experimentation and human muscle reflexes. Szentagothai has contributed a lucidly presented, well illustrated, new analysis of the synaptic architecture of motoneuron pools. The papers by Eccles, Lundberg, and Wiesendanger effectively complement each other and provide the reader with an informative account of spinal and supraspinal control of reflexes and the role of spinal interneurons. The relationship between animal experimentation and studies on man are indicated in the work of the late Dr. Hodes. Electromyographic studies in man are reviewed by Rushworth and by Hagbarth. It is apparent that

This publication embodies the proceedings of the South African Ophthalmological Society for 1962. It contains seven papers and two short reports—one on a visit to St. John's Hospital in Jerusalem and another on the Delhi Meeting of the International Congress. The principal paper, read by Mr. D. P. Choyce, of London, was entitled "The Development and Uses of All-Acrylic Anterior Chamber Implants." He advocated this type of prosthesis, and suggested the use of a built-in stenopeic aperture to obviate additional spectacle correction. In the discussion of a paper on orbital tumors by Townsend it was brought out that hydatid cysts of the orbit are the principal cause of unilateral proptosis in Capetown. In a review of some 300 cases of squint, Van Selm pointed out that vertical deviations do not "correct themselves" and that multiple operations are frequently necessary if fusion is to be achieved. The same author in a

REPAIRING GENES by taking advantage of chromosomal recombination is emerging as a promising new approach to gene therapy, according to speakers at the recent 16th International Congress of Genetics in Toronto. Although gene therapy was once thought to be nearing clinical trials, numerous technical problems have kept it in the laboratory. One principal stumbling block has been an inability to get inserted genes to express proteins at useful levels in animal models. The difficulty, many investigators say, arises from the vehicles used to transport genes into the cell. The most widely used vehicles, modified retroviruses, are essentially unguided missiles that deposit their cargo randomly about the genome. The transported genes, out of their customary positions, are usually only temporarily activated, if at all. One solution may be to repair the defective gene in place, suggests Paul Berg, PhD, director of the Beckman Center for Molecular and Genetic Medicine, Stanford (Calif)

This text is a compendium of selected papers and discussion from the first international congress of the American Association of Gynecological Laparoscopists held in New Orleans in November 1973. The papers in this text are presented by many of the most experienced teachers and proponents of laparoscopy and hysteroscopy, who are representatives from France, Germany, England, Thailand, Japan, Austria, the Netherlands, Mexico, Canada, and the United States. Laparoscopy is rapidly becoming one of the more important component parts of gynecologic practice. It has proved beneficial in the diagnosis and management of many disease entities relative to the female pelvis. The introduction of a diagnosistc tool, endoscopic in nature, that utilizes the invention of the fiberoptic system of light transmission, is helpful for diagnosis and for teaching medical students and residents about pelvic pathology, and it enables one to document such pathology by photography and cinematography. This compendium of international experts

The United States has been declared the host country for the next International Congress. This will be the 24th congress of this kind in the field of ophthalmology. The first one was held in 1857 in Brussels. The United States had extended an invitation to the International Council. The council negotiated with an organizing committee and then accepted the invitation. The organizing committee has elected A. Edward Maumenee, MD, as president and Frank W. Newell, MD, and Bradley R. Straatsma, MD, as vice presidents. Bruce E. Spivey, MD, will be secretary-general. The organizing committee also consists of secretaries who are concerned with the scientific program, scientific exhibits, and instruction courses. The organizing committee for the International Congress and the board of directors of the American Academy of Ophthalmology have now agreed to hold a joint meeting in 1982. This meeting will take place in San Francisco, Oct 30 to Nov