THYROID AND THE HEART MBRTISH 259 unchanged; the B.P. had fallen to 170/95; and the cholesterol was 210 mg. per 100 ml. However, the patient did not feel so well. Treatment was then stopped, and after four weeks the tracing had returned almost to its original normal pattern, the B.P. had risen to 210/105, and the cholesterol to 300 mg. The patient felt better for a time but then deteriorated; she finally improved on a smaller dose of thyroid.The blood pressure, especially the diastolic, was slightly raised in mild cases. In the severe spontaneous cases it was very high in one half. Nearly always it fell to near normal as the myxoedema was corrected by thyroid hormone. The possibility that the disappearance of the electrocardiographic abnormalities under treatment could be due to fall in blood pressure might be put forward. This cannot be accepted, however, because the T-wave changes in myxoedema are more widespread than in hypertension; they can be corrected very much more quickly than in primary hypertension; and, moreover, they revert just as readily when an initially low blood pressure rises with treatment.To test the effect of thyroid hormone on the electrocardiogram of patients with normal thyroid function, nine subjects were given triiodothyronine in doses of 40 to 90 jug. daily. The results are given in Table V. In those with a left ventricular predominance pattern there was some lessening of the depression of the ST segment and increase in the voltage of T; there were similar effects on the tracings of two patients with old coronary thrombosis. In one with a normal tracing thyroid hormone had no effect beyond a slight increase in rate. These effects are in keeping with the usual high T voltage in toxic goitre, for when thyroid hormone is given to a subject whose thyroid is functioning normally a mild degree of hyperthyroidism is produced. This raises the T wave and, with it, lessens the depression of the ST segment. The changes are, however, trivial in comparison with what occurs in myxoedema using the same dose of hormone.Arrhythmia.-Abnormal rhythms are conspicuously absent. Apart from heart-block, the only one recorded was an occasional extrasystole, either ventricular or auricular. While an excess of thyroid secretion promotes auricular fibrillation, lack of this seems to prevent it. Heart Size.-There was no enlargement in 14 out of 36 cases. However, pulsation was small even in these. Enlargement when present varied from slight to very great. Its amount was not always proportional to the severity of the hypothyroidism as judged by clinical, cardiographic, blood pressure, or cholesterol findings. It is probable that great enlargement is always due to pericardial effusion (Figs. 8 to 13). This is suggested by the shape of the very large heart and by the rapid shrinkage with treatment; as the face and body lose their puffiness the heart goes down at the same time.Simulation of Congestive Heart Failure.-In a severe case with cardiac enlargement there is pitting oedema of the feet and legs and engorged c...

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It has been known for about ten years that methyl fluoroacetate (MFA) chamber. Chemical analyses showed that there was little variation in concentration. After administration the animals were observed carefully and records were made of their behaviour over the whole period until their death.As this substance had a convulsive action the effects of other known convulsants were compared in the most favourable species, and for purposes of record and study a colour film was made of a dog and two monkeys after MFA, and also of monkeys after nicotine, strychnine, and metrazol. The effect of MFA on a spinal monkey was also filmed.Autopsies were made on animals directly after death. The effect of MFA on the blood chemistry was investigated in rabbits, dogs, and goats. Blood samples were collected under paraffin, and serum and plasma were separated shortly after. Samples of blood were taken into oxalate tubes for blood sugar, non-protein nitrogen, potassium, calcium, and inorganic phosphate.Haemoglobin was estimated by the Haldane carbon monoxide method, plasma proteins and non-protein nitrogen by micro-Kjeldahl digestion and nesslerisation (Wong; cf. Peters and Van Slyke, 1932), potassium by the micro-cobaltinitrite method of Kramer and Tisdall (cf. Peters and Van Slyke, 1932), calcium by the method of Kramer and Tisdall (cf. Harrison, 1930), sugar by Hagedom and Jensen's method (Peters and Van Slyke, 1932), chloride by Sendroy's method (1937), and inorganic phosphate by the method of Obermer and Milton (1932) adapted for use with a " Spekker" absorptiometer.Kymographic tracings of carotid blood pressure and respiration were obtained on cats anaesthetized with sodium barbitone, respiration being recorded by Gaddum's technique (1941), which measures the volume of air breathed in litres per minute.Observations of the clinical effects of MFA were made on both spinal and decerebrated cats, and on a monkey, and kymographic records were obtained of the knee-jerk in spinal, decerebrated and chloralosed cats by means of an electrically operated patellar hammer; in the spinal cat the action of MFA on the threshold stimulus of the flexor reflex (tibialis anticus) was also investigated (Sherrington and Liddell, 1929).A series of rats were given electrical convulsions on two successive days, and the electrical convulsive threshold was again measured one hour after a subcutaneous injection of MFA. The apparatus used for human electric convulsive therapy was employed (Golla, Walter, and Flemming, 1940).Finally, various therapeutic measures were attempted, both before and after administration of MFA, and before and after onset of convulsions; dogs were mostly used for these experiments. RESULTSToxicity by injection, by mouth, and by inhalationThe approximate LD50 doses are summarized in Table I. It is fully realized that the figures *Present address: Litfield House. Clifton Down. Bristol, 8.

Synthetic Polypeptides-Downie et al.BEICA JOURNAL 489 administered DW 75 is not absorbed with sufficient rapidity nor in sufficient quantity to be of any value in assessing adrenocortical integrity.The significance of the relatively high levels of plasma 11-OHCS at four and six hours after intravenous administration of DW 75 in the steroid-treated subjects again probably reflects the longer duration of this compound compared with that of Synacthen.Our , 1968, 4, 489-491 S ummary: Norgestrel in a dose of 50 ug. was administered daily to 188 women during 2,250 menstrual cycles. Only two pregnancies occurred because of failure of the method, giving a failure rate of 1.1 pregnancies per 100 woman-years. The method was acceptable to most of the subjects, and side-effects, other than menstrual irregularity, were minimal; 68% of the cycles were 28 ±5 days in length and 21% were less than 23 days. There did not appear to be any increased incidence of amenorrhoea. The antifertility action of continuous administration of low doses of progestogen may be due to an effect on corpus luteum function, in addition to the effects on cervical mucus, endometrium, and tubal transport of ova. The optimum dose of norgestrel appears to be in the range of 50-75 /Ag./day. Introduction Martinez-Manautou et al. (1966, 1967 showed that continuous dosage with 0.5 mg. of chlormadinone acetate daily exerted an antifertility effect, though ovulation was not always

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Summary. The effect of clomiphene on the sperm count and hormone excretion is described in a patient with Klinefelter's syndrome, having a 47 XXY karyotype, and in whom a testicular biopsy showed small areas of spermatogenesis.Clomiphene stimulated the production of morphologically normal motile spermatozoa in the absence of any marked effect on hormone output.Possible explanations for these findings are discussed.

Summary. Apparently normal but infertile women were treated by artificial insemination using fresh donor semen. In 228 couples in which the male partner was azoospermic the average monthly conception rate was 13·3% and the 12‐month cumulative rate was 82·2% (SE 2·7%). In 116 couples in which the partner was oligospermic the monthly rate was 8·7% and the 12‐month rate 66·6% (SE 5·0%, P <0·0l). Previous smaller studies have given rise to conflicting or inconclusive results, but the reduced conception rates in the partners of oligospermic men in this large study suggests that unexplained female factors, discussed in the paper, contribute to their infertility in up to a third of patients.