Intermittent claudication complicating beta-blockade Intermittent claudication is an occasional side effect of beta-adrenergic blockade' but clinical details are lacking. Beta-blocking agents may exacerbate intermittent claudication in patients with severe peripheral arterial insufficiency.2 The following cases suggest that they may also provoke claudication in patients with previouslv asymptomatic peripheral arterial disease. Case 1 A man aged 54 without previous cardiovascular symptoms was found to be hypertensive. He was treated with methyldopa and, because of probable paroxysmal nocturnal dyspnoea, with bendrofluazide. After six months propranolol 120 mg daily was substituted for methyldopa. Three weeks later he developed cold extremities and bilateral calf claudication at 150 yards. After eight weeks' treatment, during which the blood pressure fell from 220/125 to 200/120 mm Hg, propranolol was withdrawn. Claudication began to improve after three weeks and resolved within five. Seven weeks after stopping propranolol the patient could play golf. Although both feet were cool, all peripheral pulses were palpable. The

Arterial occlusive disease is a well-known complication of radiation therapy, but venous thrombosis and occlusion after radiotherapy may also occur. We report the use of an endovascular stent to treat a patient who developed peripheral venous stenosis 4 years after radiation therapy for malignant melanoma.

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This report describes a technique for removal of a segmental broken intramedullary femoral rod. Using a closed, stacked wire technique, removal of the broken hardware can be accomplished in a relatively easy and expeditious manner.

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