1. Four parameters of insulin metabolism were compared in catheterized lactating and non-lactating Friesian x Ayrshire dairy cows. 2. The four parameters, i.e. arterial and portal-venous concentrations of insulin, and pancreatic output and hepatic uptake of insulin, were approx. 2-, 3-, 3- and 5-fold higher respectively in the non-lactating cows than in the lactating cows in the normal fed state. Statistical significance was not achieved for the differences in magnitude in the case of the latter two parameters, however. 3. All four parameters increased significantly about 4-fold when non-lactating cows were infused intravenously with glucose for 48 h at a rate of 4.2 mmol/min. The parameters also increased in the lactating cows during glucose infusion, but the values reached were substantially lower than in the non-lactating cows and the increases were not statistically significant. 4. Arterial insulin concentrations doubled in the non-lactating cows during a 3 h infusion of propionate into a mesenteric vein, but remained unaltered in the lactating cows. 5. Differences in insulin concentration and output between the lactating and non-lactating cows were not consistently related to differences in either glucose concentration or glucose-entry rate. Arterial propionate concentrations were similar in both groups of cows at all times. 6. It is concluded that in the dairy cow, insulin secretion in response to an insulinotropic agent is diminished during lactation.

The relative anatomy of the internal jugular vein (IJV) was studied in 25 patients undergoing cardiac catheterization under general anaesthesia, with the use of a portable ultrasound probe. In 14 of cases the IJV was anterior, 1 anterolateral and in 10 lateral to the carotid artery between the two heads of the sternocleidomastoid muscle. At the level of the cricoid cartilage, in six cases the IJV was anterior, three anterolateral and in 16 of children the IJV was lateral to the carotid artery. When attempting to cannulate the IJV, because of the variability in relationship of the IJV to CA the technique used should be modified depending upon the level at which cannulation is attempted. The position of the IJV in the child appears to be so variable extra care should be taken when cannulating the IJV and it should not be assumed that the techniques used in adults are directly transferable.

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Medical MemorandaMIDALeJOUWNL keratodermia spread to involve all four limbs, the back, the face, and the scalp. The lesions progressed from a macular eruption to vesicular and pustular stages, finally becoming hard scaling keratotic plaques, which on the feet were painful and irritating. Fresh lesions appeared adjacent to areas of healing ( Fig. 1), and in view of their severity oral prednisone 40 mg. daily and topical hydrocortisone were prescribed. The arthritis was also treated with indomethacin with partial relief, but after a few days of steroid therapy her pyrexia subsided, joint pains were further relieved, and there was a noticeable improvement in the skin lesions. After 11 weeks in hospital she was discharged, the prednisone being gradually reduced. At the time of this report no fresh skin or mucosal lesions had appeared, and repeat radiographs of the hands, the feet, and sacroiliac joints were normal. Histological examination of involved skin ( Fig. 2) showed spongiform pustules in the upper epidermis, acanthosis, infiltration with polymorphs, and hyperkeratosis. The underlying dermis showed mild perivascular chronic inflammatory cell infiltration. (Hancock, 1960) and are painless and superficial. The mucous membrane lesions usually precede the skin lesions and may also occur before the onset of arthritis (Nicol, 1966). It is likely that the oral lesions in this patient were present on admission but were overlooked, for when the diagnosis of Reiter's disease became obvious with the eruption of keratodernia blennorrhagica, closer inspection of the tongue showed lesions practically healed. An extremely rare feature in this case was that the keratodermia involved the face. Though lesions of the scalp may extend a little on to the forehead (King, 1964), facial involvement in Reiteres disease is practically never seen (Oates, 1970).Treatment of Reiter's disease with steroids is not indicated unless the illness is severe. In the present case the administration of prednisone resulted in cessation of pyrexia for the first time since admission, healing of skin lesions, and a shortened stay in hospital.I should like to thank Professor M. D. Milne, Westminster

ABSTRACT1. Four groups of British Friesian heifers born in April (no. = 30), July (no. = 29), October (no. = 30) 1977 and January 1978 (no. =27) were allocated to one of six treatments (planes of nutrition) at a mean age of 91 days. From 91 to 365 days of age heifers on treatments 1 to 5 were given individually, according to body weight, a proprietary pellet to 126 days of age, and thereafter a diet of dried lucerne and barley. Heifers on treatments 1 and 2 were fed at the same rate whereas heifers on treatments 3 to 5 were fed at successively higher rates. Heifers on treatment 6 were fed ad libitum the proprietary pellets to 126 days of age and thereafter a 'barley beef diet. Mean live-weight gains between 91 and 365 days of age for treatments 1 and 2 combined and 3 to 6, respectively, were 0·58, 0·68, 0·75, 0·82 and 1·06 kg/day.2. Plasma progesterone concentrations were determined twice weekly in each animal. Puberty was assumed to have occurred 2 days before the start of the first period in which the progesterone concentration exceeded 1μg/1 for at least 10 days.3. There was no significant difference between treatments in mean body weight at puberty (242 kg), but age at puberty (347, 305, 288, 301 and 239 days for treatments 1 and 2 combined and 3 to 6, respectively) was inversely related to rate of live-weight gain between 91 and 365 days of age. However, within each treatment group the fastest growing heifers reached puberty at the same age but at a heavier body weight than the slowest growing heifers.4. There were significant seasonal effects on age and body weight at puberty. The most rapidly reared animals (treatment 6) born in January and April were, on average, 52 days younger and 54 kg lighter at puberty than those born in July and October, but the effects of season of birth in other treatments were different.5. There was no significant difference between treatments in the number of conceptions (mean 0·67) achieved at first service by an Aberdeen Angus bull introduced when the heifers were 350 days of age.

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Measurements were made of the plasma concentrations of testosterone, progesterone and oestradiol-17 beta during the oestrous cycle of the ewe, and of the plasma concentrations of testosterone and progesterone during the oestrous cycle of the heifer. The maximum concentration of progesterone in the heifer was nearly twice that in the ewe. The maximum concentration of testosterone was similar in both species and occurred at the onset of luteolysis; in the ewe the peak concentration of 19.5 ng/ml plasma was significantly greater (P less than 0.05) than the concentrations of testosterone measured during the remainder of the oestrous cycle.

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