(Dumonde, 1970). The ability of these soluble factors to inhibit the migration of cultured macrophages and leucocytes provides one measure ofcellular hypersensitivity (see Dumonde and Maini, 1971). In this paper we describe an improved method for detecting the inhibition of leucocyte migration by specific antigen which is based on the technique of Bendixen and S0borg (1969 90 min in a non-wettable plastic sterile test tube, by which time the red cells had settled at the bottom, leaving a leucocyte-rich plasma layer above. The leucocytes were centrifuged at room temperature at 150 g for 10 min, washed thrice in Waymouth's medium containing 10% horse serum, and resuspended in the medium at 7 x 107 leucocytes/ml.Micro-capillaries (20 IlI volume, Drummond microcaps2) were cut in two equal parts to give a 10 ,ul capillary size and these were filled with the leucocyte suspension and plugged at one end with wax. The 10 pl capillaries were placed in a test tube and spun at 600 g for five min; these were cut at the cell-fluid interface and were mounted on silicone dabs in the chambers. The chamber consisted of a plastic ring 16 mm diameter, 2 mm high, mounted with silicone grease on an ether-cleaned glass slide (Fig. la)

SummaryIn 8 out of 32 juvenile patients suffering from chronic polyarthritis and in one patient with dermatomyositis, raised transaminase levels were found; the salicylate level was above 35 mg/100 ml in all except one. Reduction in the salicylate level led to a prompt fall in the serum transaminases. Despite a rise in alkaline phosphatase in three cases there was no other evidence of liver dysfunction in the children. Only one of the adults showed a rise in transaminase levels, and she had mild cirrhosis. IntroductionOur attention was drawn to the association of increased levels of serum transaminases with high serum salicylate levels in a girl with juvenile chronic polyarthritis admitted routinely for establishment on a salicylate regimen. She complained of feeling unwell and was found to have mild hepatomegaly and raised transaminase levels; at this time her serum salicylate level had risen to 45 mg/100 ml. On stopping aspirin therapy the transaminase levels rapidly returned to normal and the hepatomegaly disappeared. In view of this 50 further patients were studied.

SummaryLaboratory diagnosis of antiphospholipid antibodies is important in patients with clinical features of the antiphospholipid syndrome, such as thrombosis and fetal loss. We have developed a novel method for the detection of antiphospholipid antibodies using flow cytometry. Anionic phospholipids cardiolipin, phosphatidylserine and phosphatidylinositol are coated onto polystyrene beads of different sizes, allowing detection and semiquantitation of their respective phospholipid antibody isotypes. The results of the flow cytometric method closely correlate those of the standardised anticardiolipin enzyme-linked immunosorbent assay (ELISA), but the method is quicker and is versatile in its ability to detect IgG, IgM and IgA antibody isotypes at the same time. The method promises to be useful in evaluating the significance of phospholipid specificity and antibody isotypes in patients with the antiphospholipid syndrome.

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A woman with rheumatoid arthritis was treated with penicillamine and developed myasthenia gravis. This drug-induced disease was associated with characteristic autoantibodies to acetycholine receptor. After discontinuing the drug, her symptoms improved and the antibody titers fell. Penicillamine is now being used much more frequently in the treatment of rheumatoid arthritis and it is likely that this complication will become more prevalent.