John J. Fahey

Trigger-finger In Adults And Children

A comparison of the incidence, etiology, symptoms, pathological variations, and treatment in adults and children with trigger-finger discloses some interesting facts.The occurrence in twin children, previously reported by us3, is one of the few instances of familial involvement.The occurrence in twi

Subtotal Resection and Grafting in Selected Cases of Solitary Unicameral Bone Cyst

Twenty cysts were treated by excision of most of the cyst wall, including bone, and grafting with struts of autologous or homologous bone. Eleven cysts were in the active phase and nine were in the latent. All but one was cured without recurrence, and that cyst healed after a second operation. The ages of the patients with active cysts ranged from four and a half to ten years; one patient was twelve years old. Data on twenty other patients, some treated by curettage and bone-grafting and some (six) in whom early healing followed fracture, are also given.

Xanthoma of the Achilles Tendon: Seven Cases With Familial Hyperbetalipoproteinemia

Seven patients with xanthomas in the Achilles tendons and associated Type-II hyperbetalipoproteinemia are reported. Resection of the lesion in four patients was successful, and there was only one recurrence after six years. Two patients had painful xanthomas of their plantar fascia, similar to the involvement of the Achilles tendons. One had a resection of the plantar lesion. Of 173 cases of Achilles tendon xanthoma found in the English literature, 119 with adequate data are tabulated. Autosomal dominant inheritance and frequent association with extensor-tendon xanthomas of the hands and with tuberous xanthomas were noted. A strong tendency to recurrence was observed in surgically removed Achilles tendon lesions. Surgical intervention is carried out for cosmetic and symptomatic reasons.

Significance of Early Appearance of Neutralizing Substances in Poliomyelitis of Man.

Although it has long been known that the serum of patients convalescent from acute anterior poliomyelitis contains an antiviral substance, the fact that a similar substance is present in the blood of the majority of normal adults has been recognized only in recent years. 1 , 2 By analogy to the known subclinical acquisition of immunity against diphtheria, the assumption has been made that a similar mechanism is operative in poliomyelitis. Such a belief postulates wide dissemination of the virus with a minor incidence of actual paralysis. Endocrine factors have been suggested in certain recent experiments. 3 However, another group of investigators 4 has been unable to reproduce the data of the first group. Further, the exact role that the poliocidal substances play in preventing infection under natural conditions and in recovery from the disease has not been elucidated, it having been assumed that these substances are the humoral expression of the immune state. One of us, 1 in collaboration with others, showed that occasional samples of convalescent human serum were devoid of neutralizing substances, while Howitt 5 found 80 of 141 samples taken weeks or months after an acute attack to be likewise without these substances. She attributed her findings to the fact that many of her patients received convalescent serum therapy. In an effort to obtain further information upon the behavior of the poliocidal substances following an acute attack of the disease, we have titrated the serums from patients obtained as soon as possible after the onset of the acute disease and again after several months. Each of these serums has been mixed in vitro in several dilutions with 10 paralyzing doses of the virus (PMV) contained in a one percent centrifuged emulsion of glycerolated spinal cord removed from monkeys (Macaca mulatta) at the height of paralysis. Injection of the serum-virus mixtures intracerebrally into unused rhesus monkeys was the indicator of unneutralized virus.