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Serum concentrations of LH and FSH and their response to the separate administration of GnRH (100 micrograms i.v.) and TRH (200 micrograms i.v.) have been studied preoperatively in 12 patients with a clinically functionless pituitary adenoma, of whom nine (3F: 6M) were found to secrete gonadotrophins in vitro. In three patients with a gonadotrophin-secreting adenoma (GSA) the pulsatile release of LH and FSH was also assessed preoperatively. An elevated serum FSH was recorded in six of nine patients with a GSA, and was subnormal in one, whilst an elevated LH was recorded in only two and was subnormal in six. A doubling of LH occurred in only four of the nine patients after GnRH and in three of six after TRH. None of the three patients with a non-GSA was shown to have an aberrant response to GnRH or TRH. In patients with a GSA, pulsatile release of LH and FSH was usually asynchronous and neither hormone demonstrated any regular harmonic pattern. These data show that in patients with a GSA the serum FSH level is usually elevated but this is not invariable, and the LH may well be low. Pathological responses of LH are frequently found following the administration of either GnRH or TRH and these stimulation tests should be performed separately in patients presenting with a clinically 'non-functioning' pituitary tumour to assist in the preoperative diagnosis. The absence of normal LH and FSH pulsing also appears to be a feature of GS adenomas, and suggests that tumorous gonadotrophin secretion is not under physiological control by hypothalamic GnRH.

This paper describes the procedure and outcome of an audit exercise designed to identify the equipment of choice from among the nasogastric (NG) tubes available on the UK market. In order to assess some of these in a systematic way, a working party of dietitians and nurses was established. Standards expected from a NG tube were set and agreed. These were then used to evaluate seven tubes to see which reached the agreed standard. This was not an exhaustive survey of all available tubes on the market, but a selection of those commonly available. Among the seven tubes investigated, the Corslo®Merck tube was found to be the NG tube of choice in Oxfordshire. Future reassessments will be required as new NG tubes become available.

The 1H (270, 400 MHz) and 13C (67.5 MHz) NMR spectra of some 4-methyl- (also 4-n-propyl- and -isobutyl)-4-(3-hydroxy- and 3-methoxy-phenyl)piperidines and their 3-methyl diastereoisomers are reported. Many of the compounds had opioid ligand activities. The data were analysed in terms of preferred conformation and configuration (3-methyl derivatives). Only compounds with preference for axial 4-aryl chair conformations displayed marked agonist properties and the one potent antagonist, cis-1,3,4-trimethyl-4-(3-hydroxyphenyl)piperidine, favoured an equatorial 4-aryl chair.

Atracurium besylate, 2,2′-(3,1 l-dioxo-4,10-dioxatridecylene}-bis-[6,7-dimethoxy-l-(3,4-dimethoxybenzyl)-2-methyl 1,2,3,4-tetrahydroisoquinolinium] dibenzenesulphonate is a potent non-depolarising (competitive) neuromuscular blocking agent in the cat, monkey, dog and anaesthetised man. In man, it caused complete paralysis of the tetanic response of the adductor pollicis muscles at doses of 0.2 mg/kg. Blockade was of medium duration with rapid spontaneous recovery, and was readily reversed by neostigmine. The electrocardiogram, heart rate, arterial blood pressure and central venous pressure were virtually unchanged following doses of 0.2-0.4 mg/kg. Intubation was readily accomplished in 1.5-2 min after administration of 0.25-0.3 mg/kg.

The stereochemistry of diastereoisomeric propionyl esters of 4-(2-furyl)-3-methyl-1-phenethylpiperidin-4-ols has been established by 13C NMR analysis. Both isomers, after acid-catalysed ethanolysis, are converted to the corresponding 4-ethoxy derivative of configuration (t-3-Me, r-4-OEt) that correlates with its analgesic properties.

La reaction de la methyl-8 aza-8 bicyclo[3.2.1] octanone-6(tropanone-6) avec les halogenures d'arylmagnesium donne selectivement les aryl-6β hydroxy-6α methyl-8 aza-8 bicyclo[3.2.1] octanes (aryl-6β hydroxy-6α tropanes). Les donnees 1 H et 13 C RMN sont rapportees pour ces alcools et leurs derives prepares comme des agonistes et antagonistes potentiels des recepteurs opiaces. Les resultats des etudes de 1 H RMN de l'hydroxy-6 tropanone-3, dont la synthese a ete decrite en 1952, confortent la stereochimie 6β proposee pour l'hydroxyle