Paul H. Curtiss

Transitory demineralization of the hip in pregnancy. A report of three cases.

Three cases have been presented of a syndronme occurring in pregnant women. This syndrome is characterized by pain of varying severity in one or both hips or thighs and develops in the last trimester of pregnancy. Roentgenograms show a spotty demineralization with sharply localized margins, involving one or both femoral heads, a small part of the femoral neck, and the acetabulum. In each of the three patients, the pain subsided and the roentgenographic appearance returned to normal within several months after delivery. We do not know the cause of this syndrome, but suspect it to be of neurogenic origin.

CHANGES PRODUCED IN THE SYNOVIAL MEMBRANE AND SYNOVIAL FLUID BY DISEASE.

Witimini the joint, the synovial membrane lines the fibrous capsule, covers intraarticular ligaments amid temidonis, amid is reflected onto time intracapsular’ bonie. Pimysiologically, the membrane is unrelated to the fibrous capsule, fn’om ms-lmich it differ’s mmstructure amid function. The miner surface layer (intima) imas an abundant 1)100(1 supply and is predominantly cellular; the subsyniovial layer’ is less vascular and iii it fibers predominate over cells. The subsynovial layer merges on its outer

IMMUNOLOGIC FACTORS IN HOMOGENOUS BONE TRANSPLANTATION. I. SEROLOGICAL STUDIES

The successful use of relatively small amounts of hom3genous preserved bone has been repeatedly demonstrated both experimentally and clinically. The use of massive homogenous bone grafts, with rare reported exceptions, has not met with the same success. In previously reported experiments on whole kneejoint transplants in dogs by one of the authors,‘ marked, consistent, gross, and microscopic differences were noted in the homogenous as compared with the autogenous joints. The former showed no retention of living cells, slow osteogenesis, and ultimate severe degenerative changes similar to those seen in avascular necrosis. The work reported here was done in an attempt to determine if these daerences in the behavior of autogenous and homogenous whole joints could be explained on the basis of an immunologic response to homogenous whole bone acting as an antigen. It has been reported as a clinical observation in the literature dealing with bone transplantation that incompatibility of blood types between the donor and recipient has no bearing on the success or failure of the graft. The authors, however, have been unable to find any experimental work that tends to prove or disprove this assumption in regard to bone transplantation. The presence of the A and/or B group specific substance as a source of potential incompatibility was an obvious starting point for experimental observations on the possible antigenicity of whole bone grafts, as bone transplants invariably contain varying amounts of blood. There is the additional possibility that bone tissue per se contains the A and/or B substance that is widespread in the tissues of persons of those types. The reports by Young et al?, on the determination of “blood groups” in dogs suggested a potentially suitable research animal. They have described five “types” occuring in dog red blood cells that were antigenically distinct, the most potent of which was the “canine A factor” which wasable to produce high titer “anti-A” antibodies capable of hemolysing A positive red cells rapidly both in vivo and in vitro. Through the kindness of Doctor Lawrence E. Young and Doctor William A. O’Brien of the University of Rochester Medical School, a supply of “anti-A” serum was obtained which was used to type and classify dogs into “A positive” and “A negative” groups. The demonstrated ability of the “A” antigen to produce a potent “anti-A” antibody was the basic research tool used in the serological experiments reported here and in the histological experiments to be reported a t a later date.

Spinal-cord tumor--a cause of progressive neurological changes in children with scoliosis. A report of three cases.

Three cases of spinal-cord tumor causing progressive neurological changes in children with scoliosis have been presented. In each patient a diagnosis of poliomyelitis had been made in early childhood, and the later neurological changes which appeared had been attributed to the scoliosis. We wish to emphasize the importance of following such cases of presumed poliomyelitis with periodic examinations to rule out other neurological diseases, and, if scoliosis appears, to seek an intradural as well as an extradural cause of progressive neurological symptoms.

The Hunchback Carpal Bone

Recognition of an os styloideum may prevent the embarrassment of its being mistaken for a more serious entity, such as fracture or tumor. In symptomatic cases, surgical removal of the prominence may be done, although the reports as to the lasting value of this are conflicting.