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We present the case of a 66-year-old man under surveillance for oropharyngeal malignancy. The presentation was that of recent onset recurrent syncopal attacks associated with neck pain. Both bradycardia and hypotension were seen during the syncopal events. Although recurrence of malignancy had not been proven at the time of presentation, this was subsequently confirmed. In this case syncope was successfully managed with Midodrine, and permanent pacemaker implantation was avoided. A review of the literature identified similar cases, where the presumptive mechanism for syncope is mediated via the glossopharyngeal nerve. Such cases follow a similar clinical course, with an unpredictable response to standard therapies, including pacemaker implantation. Clinicians should be aware that syncope associated with head and neck cancer may herald recurrence of malignancy.

Sound therapy is widely used as an ingredient in the treatment of people with tinnitus. This paper examines the evidence concerning sound therapy. A literature search was carried out in order to identify papers that distinguish the effects of sound therapy from the effects of other elements in tinnitus therapy. Few papers allow this distinction. The evidence from those papers that do identify sound therapy as a separate component of treatment indicates that sound therapy without counselling offers no benefit to patients with tinnitus but that counselling alone is of benefit. The evidence concerning whether sound therapy results in additional benefit to that offered by the psychological component of tinnitus therapy is mixed but overall it suggests that sound therapy results in little or no extra benefit. It is likely that when sound therapy does benefit people with tinnitus this effect is mediated by psychological factors.

The effects of duration and compliance of seating surfaces on reactive hyperemia within the skin overlying the ischial tuberosities was determined in four normal, one paraplegic and one cerebral palsy subject. Reactive hyperemia was demonstrated thermographically after short durations (ie, 5, 10, and 15 minutes) of seating on a hard surface. The magnitude of hyperemic response increased significantly (p < .001 for 15 v 5 minutes; p = .019 for 15 v 10 minutes; p = .001 for 10 v 5 minutes) with increased duration of seating. In all six subjects studied, the maximum postseating blood flow continued to increase with up to 15-minute seating on a hard surface, and the mean maximum response was positively correlated with duration of seating (4 = 0.918, p < 0.001). Although there was good correlations between magnitudes of interface pressures measured and vascular responses within each individual, there was no such direct correlation between individuals.

Calcium uptake by sarcoplasmic reticulum vesicles from batrachotoxin- or surgically denervated muscle was measured by both isotopic and energy dispersal X-ray procedures. In the presence of inorganic phosphate, vesicles obtained from both chemically and surgically denervated muscle accumulated less calcium than control vesicles. Intravesicular calcium appeared to be present either as a crystalline or granular precipitate. Our results support the concept that batrachotoxin, by blocking both axonal transport and impulse activity, results in a chemical denervation of the muscle.

PARKER (1943) fed graded amounts of thyroactive iodocasein to five lots of Rhode Island Red chicks during a period of 12 weeks. At the optimum level a slightly greater rate of growth was observed in comparison to the controls and a rather marked stimulation of feather growth. Irwin, Reineke and Turner (1943) confirmed these results using White Plymouth Rock chicks. The effect of thyroactive iodocasein, hereafter referred to as protamone ** on certain gland and organ weights was also reported. In this experiment it was noted that the carcass of the protamone-fed chicks at 12 weeks contained decidedly less fat than the control chicks, indicating that the growth process was being stimulated at the expense of fat deposition. Further, the feeding of protamone had caused a marked suppression of the thyroid gland weight and probably its function. It seemed of interest to determine the effects on body weight, fattening, and gland . . .

MANY investigators during the past three decades have reported on the various effects of feeding fresh or desiccated thyroid to chickens. Results have been variable, dependent upon dosage level and potency of the material. Most of the work reported has concerned adult stock, and the data relative to chicks and young growing stock appears to be meager. Crew and Huxley (1923) fed dried thyroid to 12 chicks and found no significant difference in weight between the control and experimental group. It is known that thyroid given in excessive amount will retard the rate of growth or even cause a loss of body weight. However, some investigators have reported acceleration of the growth rate in dogs, rats, and mice when thyroid was fed in optimum amounts. Recently Koger and associates (1942 (1943) reported improvement of growth and appetite in mice receiving subcutaneous injections of crystalline thyroxine and the feeding of thyroactive . . .